akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2020.156akusherstvo-790Research ArticleOriginal articlesОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯEffect of postoperative rehabilitation on quality of life in patients with vulvar cancerВлияние послеоперационной реабилитации на качество жизни больных раком вульвыhttps://orcid.org/0000-0001-7738-1858БлбулянТ. А.BlbulyanT. A.

Блбулян Татевик Арменовна – ассистент кафедры акушерства и гинекологии № 2

Армения, 0025 Ереван, ул. Корюна, д. 2

Tatevik А. Blbulyan – MD, Assistant, Department of Obstetrics and Gynecology № 2

2 Koryun Str., Yerevan 0025, Armenia

https://orcid.org/0000-0002-7456-2386СолоповаА. Г.SolopovaA. G.

Солопова Антонина Григорьевна – д.м.н., профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова

Россия, 109004 Москва, ул. Земляной Вал, д. 62

Scopus Author ID: 6505479504

Researcher ID: Q-1385-2015

Antonina G. Solopova – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, N.F. Filatov Clinical Institute of Children's Health

62 Str. Zemlyanoi Val, Moscow 109004, Russia

Scopus Author ID: 6505479504

Researcher ID: Q-1385-2015

antoninasolopova@yandex.ruhttps://orcid.org/0000-0003-1115-3144ИвановА. Е.IvanovA. E.

Иванов Александр Евгеньевич – к.м.н., врач-онколог высшей квалификационной категории, зав. онкогинекологическим отделением

Россия, 105005 Москва, Бауманская ул., д. 17

Alexander E. Ivanov – MD, PhD, Head of the Department of Oncogynecology

17/1 Baumanskaya Str., Moscow 105005, Russia

https://orcid.org/0000-0002-4003-9431КуркинаЕ. И.KurkinaE. I.

Куркина Елена Игоревна – студент Клинического института детского здоровья имени Н.Ф. Филатова

Россия, 109004 Москва, ул. Земляной Вал, д. 62

Elena I. Kurkina – Student

62 Str. Zemlyanoi Val, Moscow 109004, Russia

Ереванский государственный медицинский университет имени Мхитара ГерациРоссияYerevan State Medical University after Mkhitar HeratsiRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияSechenov UniversityRussian FederationГБУЗ «Городская клиническая онкологическая больница № 1 Департамента здравоохранения города Москвы»РоссияCity Clinical Oncology Hospital № 1, Moscow Healthcare DepartmentRussian Federation202013102020144415425Copyright © Blbulyan T.A., Solopova A.G., Ivanov A.E., Kurkina E.I., 20202020Блбулян Т.А., Солопова А.Г., Иванов А.Е., Куркина Е.И.Blbulyan T.A., Solopova A.G., Ivanov A.E., Kurkina E.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/790Aim

Aim: to evaluate the quality of life parameters dynamics in patients with vulvar cancer I and II stages during postoperative rehabilitation.

Materials and Methods

Materials and Methods. A prospective comparative randomized study included 47 women with vulvar cancer I–II stages, aged 38 to 70 years, with an average age of 56.3 ± 3.9 years. Patients were randomized into 2 groups: 24 of them underwent postoperative rehabilitation and 23 were included in the comparison group. Quality of life and sexual function, as well as psycho-emotional state were assessed using a set of questionnaires: quality of life of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, Functional Assessment of Cancer Therapy-General (FACT-G) with an extension for vulvar cancer, Female Sexuality Index (FSFI) and WAM (well-being, activity, mood).

Results

Results. Patient who receiving postoperative rehabilitation even during the first three months, a reliable positive dynamics of all parameters of FSFI and EORTC, except cognitive function, was noted. At the same time, in the patients not undergoing postoperative rehabilitation program there was no reliable difference in the results of the questionnaires, except for FSFI, but the severity of changes was significantly less than in the patients of the research group. Dynamics in the EORTC parameters in women in postoperative rehabilitation averaged 14.8 points with 7.8 points in the comparison group. In the FACT-G questionnaire, the dynamics were even more pronounced with 19.9 and 6.8 points respectively. There was a reliable positive trend in improving the quality of sexual life and a decrease in the percentage of women suffer from pain and discomfort during sexual intercourse: from 25,0 % (n = 6) to 4,2 % (n = 1) in the study group and from 21,7 % (n = 5) to 13,0 % (n = 3) in the comparison group. Improvement in sexual desire and satisfaction during the year was noted in 5 (20.8 %) women in the study group and only 2 (8.7 %) in the comparison group.

Conclusion

Conclusion. The developed program of postoperative rehabilitation of patients with vulvar cancer, which includes individual and group psychotherapy, "anti-cancer diet therapy", dosed physical activity, dynamic correction of vaginal biocoenosis showed high efficiency already during the first 6 months. All patients with vulvar cancer in the postoperative period should receive active rehabilitation aimed at correction of psycho-emotional state and sexual function, which will improve the quality of life and improve further prognosis.

Цель исследования

Цель исследования: оценить качество жизни больных раком вульвы I–II стадии в процессе послеоперационной реабилитации.

Материалы и методы

Материалы и методы. В проспективное рандомизированное сравнительное исследование было включено 47 больных раком вульвы I–II стадии в возрасте от 38 до 70 (56,3 ± 3,9) лет. Участницы были рандомизированы на 2 группы: 24 из них проходили программу послеоперационной реабилитации, включавшей индивидуальную и групповую психотерапию, «противораковую диету», дозированную физическую активность, динамическую коррекцию биоценоза влагалища (основная группа); 23 пациентки, не проходившие программу реабилитации, составили группу сравнения. Качество жизни и сексуальной функции, а также психоэмоциональное состояние оценивали с помощью комплекса опросников: качество жизни Европейской организации исследования и лечения рака QLQ-C30 (англ. European Organisation for Research and Treatment of Cancer, EORTC), функциональная оценка терапии рака (англ. Functional Assessment of Cancer Therapy-General, FACT-G) с расширением для рака вульвы, показатели индекса женской сексуальности (англ. Female Sexual Function Index, FSFI) и САН (самочувствие, активность, настроение).

Результаты

Результаты. В основной группе уже в течение первых 3 мес отмечен рост всех параметров FSFI и EORTC, кроме когнитивной функции. При этом у пациенток группы сравнения не было различий по результатам опросников, кроме показателей FSFI, и выраженность изменений была существенно меньше, чем у участниц основной группы. Изменение показателей EORTC в основной группе составило в среднем 14,8 баллов и только 7,8 баллов в группе сравнения. Отмечен рост показа- телей EORTC и снижение доли женщин, испытывающих боль и дискомфорт при половых контактах: с 25,0 % (n = 6) до 4,2 % (n = 1) в основной группе и с 21,7 % (n = 5) до 13,0 % (n = 3) в группе сравнения. По опроснику FACT-G рост показателей был более выраженным и составил 19,9 и 6,8 баллов соответственно. Усиление полового влечения и удовлетворенность половой жизнью в течение года отметили 5 (20,8 %) пациенток основной группы и только 2 (8,7 %) женщины группы сравнения.

Заключение

Заключение. Разработанная программа послеоперационной реабилитации продемонстрировала высокую эффективность в течение первых 6 мес. Всем больным раком вульвы в послеоперационном периоде показаны активные реабилитационные мероприятия, направленные на коррекцию психоэмоционального состояния и сексуальной функции, что позволит повысить качество жизни и улучшить дальнейший прогноз.

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The authors declare that there are no conflicts of interest present.