{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T14:14:56Z","timestamp":1771683296754,"version":"3.50.1"},"reference-count":36,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objective: Exclusive radiotherapy, including external beam radiotherapy (EBRT) and interventional radiotherapy\/brachytherapy (IRT\/BT), with concurrent cisplatin-based chemotherapy, represents the standard of care in patients with locally advanced cervical cancer (LACC). The emerging topic of vaginal toxicity has become a key endpoint in LACC management, although different approaches and non-standardized procedures were available. Our aim was to analyze a nationwide study of the attitudes of Italian gynecological radiation oncology teams in the management of LACC patients\u2019 vaginal toxicities. Methods: A nationwide survey of radiation oncologists specializing in the treatment of gynecological malignancies was performed, using the free SurveyMonkey platform, consisting of 26 items. The questionnaire was proposed by the Italian Association of Radiation Oncologists (AIRO) gynecological working group to all 183 Italian radiation oncology institutions, as per AIRO\u2019s website. Results: Fifty-eight questionnaires (31%) were completed and returned. The assessment of acute and late vaginal toxicities was systematic in 32 (55.2%) and 26 (44.8%) centers, respectively. In the case of EBRT, 70.7% of centers, according to the contouring and treatment plan data, did not contour the vagina as an organ at risk (OAR). Vaginal dose constraints were heterogeneous for both EBRT and IRT\/BT. Local treatment to prevent vaginal toxicity was prescribed by 60.3% of radiation oncologists, mostly vaginal hyaluronic acid cream, and one center recommended vaginal estrogen preparations. During follow-up visits, vaginal toxicity was considered an issue to be investigated always (n = 31) or in sexually active women only (n = 11). Conclusions: This survey showed that wide variation exists with regard to recording and treating vaginal toxicity after exclusive chemoradiation for cervical cancer, underscoring the need to develop more comprehensive guidelines for contouring e-dose reporting of the vagina, so as to implement clinical approaches for vaginal toxicity.<\/jats:p>","DOI":"10.3390\/medicina59020385","type":"journal-article","created":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T01:59:24Z","timestamp":1676599164000},"page":"385","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Vaginal Toxicity Management in Patients with Locally Advanced Cervical Cancer following Exclusive Chemoradiation\u2014A Nationwide Survey on Knowledge and Attitudes by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Gynecology Study Group"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5119-8358","authenticated-orcid":false,"given":"Francesca","family":"De Felice","sequence":"first","affiliation":[{"name":"Radiation Oncology, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, \u201cSapienza\u201d University of Rome, Viale Regina Elena 326, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Vicenzi","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Radiation Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via \u00c1lvaro del Portillo, 200, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0529-201X","authenticated-orcid":false,"given":"Gabriella","family":"Macchia","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Gemelli Molise Hospital, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli, 1, 86100 Campobasso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7965-7966","authenticated-orcid":false,"given":"Andrea","family":"Vavassori","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, European Institute of Oncology IRCCS, Via Giuseppe Ripamonti, 435, 20141 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabetta","family":"Perrucci","sequence":"additional","affiliation":[{"name":"Radiation Oncology Section, Perugia General Hospital, Piazzale Giorgio Menghini, 3, 06129 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annamaria","family":"Cerrotta","sequence":"additional","affiliation":[{"name":"Radioterapia Oncologica, Fondazione IRCS, Istituto Nazionale dei Tumori di Milano, Via Giacomo Venezian, 1, 20133 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3507-7051","authenticated-orcid":false,"given":"Valentina","family":"Lancellotta","sequence":"additional","affiliation":[{"name":"U.O.C. Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Via Giuseppe Moscati, 31, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Meregalli","sequence":"additional","affiliation":[{"name":"Radioterapia Ospedale San Gerardo-ASST Via G. B. Pergolesi, 33, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorena","family":"Draghini","sequence":"additional","affiliation":[{"name":"Radiotherapy Oncology Centre, S. Maria Hospital, Viale Tristano di Joannuccio, 05100 Terni, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonietta","family":"Augurio","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, \u201cSS Annunziata\u201d Hospital, \u201cG. D\u2019Annunzio\u201d University, Via dei Vestini, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vitaliana","family":"De Sanctis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Translational Medicine, \u201cSapienza\u201d University of Rome, Radiotherapy Oncology, St. Andrea Hospital, Via di Grottarossa 1035, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"iv72","DOI":"10.1093\/annonc\/mdx220","article-title":"Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"28","author":"Marth","year":"2017","journal-title":"Ann. Oncol."},{"key":"ref_2","unstructured":"(2022, July 10). National Comprehensive Cancer Network (NCCN) Guidelines. Cervical Cancer, Version 1.2022. 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