Objectives: We aimed to study the efficacy of fractional CO2laser for genitourinary syndrome of menopause (GSM) symptoms in breast cancer (BC) survivors through a randomized, sham-controlled study, followed by an open-phase study assessing the impact of additional treatments. Methods: BC survivors with GSM were randomized to receive either three sessions of intravaginal CO2laser or sham treatment every 3–4 weeks. The laser’s energy was 45–60 mJ/pixel. Outcomes were compared one month following the last session. Participants initially receiving laser treatment were offered three more sessions, while those receiving sham had six laser sessions in an open-label study. Results: Thirty-four BC survivors were randomized to laser (n = 19) or sham (n = 15) treatments. Dyspareunia and intercourse dryness scores improved in both groups one month post-treatment, without a significant advantage of laser over sham. The laser treatment resulted in a reduction in daily dryness (−1.30 ± 0.55,p= 0.017), an increase in vaginal hydration (3.24 ± 1.13,p= 0.004), and an increase in Vaginal Health Index (VHI) (2.26 ± 0.50,p< 0.001). Most participants (18/19 and 9/15, respectively) opted to continue laser treatments after unblinding, resulting in 27 patients receiving six laser treatments. Increasing the number of laser treatments was associated with a constant improvement in Visual Analogue Score (VAS) scores for dyspareunia, intercourse dryness, daily dryness, burning, discomfort, itch, and average VAS, as well as pH, VHI, and hydration. Conclusions Three fractional CO2laser treatments for BC survivors reduced daily dryness but did not improve dyspareunia and sexual dryness when compared to sham in this randomized trial. Increasing the number of treatment sessions seemed to improve outcomes; however, it remained clinically insufficient, even after six treatments.
目的：本研究旨在通过一项随机假对照试验，评估点阵式CO2激光对乳腺癌幸存者绝经期泌尿生殖综合征症状的疗效，并随后开展开放期研究以评估追加治疗的效果。方法：将患有绝经期泌尿生殖综合征的乳腺癌幸存者随机分组，分别接受每3-4周一次、共三次的阴道内CO2激光治疗或假治疗。激光能量设置为45-60 mJ/像素。在最后一次治疗结束一个月后比较疗效指标。在开放标签研究中，初始接受激光治疗的参与者被提供额外三次治疗，而假治疗组则接受六次激光治疗。结果：34名乳腺癌幸存者被随机分配至激光治疗组（n=19）或假治疗组（n=15）。治疗后一个月，两组的性交痛和性交干燥评分均有改善，但激光治疗未显示出显著优于假治疗的优势。激光治疗使日常干燥评分降低（-1.30±0.55，p=0.017）、阴道水合度增加（3.24±1.13，p=0.004）、阴道健康指数提升（2.26±0.50，p<0.001）。揭盲后大多数参与者（分别为18/19和9/15）选择继续接受激光治疗，最终27名患者完成六次激光治疗。增加治疗次数与性交痛、性交干燥、日常干燥、灼烧感、不适感、瘙痒及平均视觉模拟评分，以及pH值、阴道健康指数和水合度的持续改善相关。结论：本随机试验表明，与假治疗相比，三次点阵式CO2激光治疗可改善乳腺癌幸存者的日常干燥症状，但对性交痛和性交干燥无显著改善效果。增加治疗次数可能改善疗效指标，但即使完成六次治疗，其临床改善程度仍显不足。
肿瘤(癌症)患者之家