Abstract：
Patients with anal squamous cell carcinoma (SCC) are treated with sphincter-preserving radiation therapy and concurrent chemotherapy, achieving excellent oncologic outcomes. Patients, however, may experience treatment-related morbidity including sexual dysfunction. The objective of this systematic review was to review the literature on sexual dysfunction in female patients treated for anal cancer and to identify knowledge gaps.
This systematic review was registered in PROSPERO prior to initiation. Databases searched included MEDLINE, Embase, PubMed, Cochrane, and Google Scholar. There were no restrictions on the study time period. Studies were limited to English. All study designs were included except review articles, letters to the editor, and case reports with less than ten patients.
In total, 1801 studies were retrieved and 19 met the inclusion criteria, including: 13 cross-sectional surveys, 3 prospective studies, 1 longitudinal intervention study, 1 retrospective chart review, 1 case control study. Sexual function was assessed using the female sexual functioning index (FSFI), EORTC-QLQ-CR30 and -CR38; response rates were low (<50 % in most studies). Sexual dysfunction was reported by up to 85 % of women; the most common symptoms being dyspareunia (17-65 %), vaginal dryness (22-88 %), and loss of libido (38-95 %). Gastrointestinal issues, such as bowel problems, and body image concerns additionally affected sexual function and quality of life.
Sexual dysfunction is a common issue affecting most female patients treated for anal cancer and there is a paucity of evidence on the management of this important survivorship issue. There is additionally a lack of ethnic, economic, and educational diversity and there are no studies addressing the unique needs of LGBTQ individuals - future studies should make a concerted effort to include a diverse patient population.
This systematic review was registered in PROSPERO prior to initiation. Databases searched included MEDLINE, Embase, PubMed, Cochrane, and Google Scholar. There were no restrictions on the study time period. Studies were limited to English. All study designs were included except review articles, letters to the editor, and case reports with less than ten patients.
In total, 1801 studies were retrieved and 19 met the inclusion criteria, including: 13 cross-sectional surveys, 3 prospective studies, 1 longitudinal intervention study, 1 retrospective chart review, 1 case control study. Sexual function was assessed using the female sexual functioning index (FSFI), EORTC-QLQ-CR30 and -CR38; response rates were low (<50 % in most studies). Sexual dysfunction was reported by up to 85 % of women; the most common symptoms being dyspareunia (17-65 %), vaginal dryness (22-88 %), and loss of libido (38-95 %). Gastrointestinal issues, such as bowel problems, and body image concerns additionally affected sexual function and quality of life.
Sexual dysfunction is a common issue affecting most female patients treated for anal cancer and there is a paucity of evidence on the management of this important survivorship issue. There is additionally a lack of ethnic, economic, and educational diversity and there are no studies addressing the unique needs of LGBTQ individuals - future studies should make a concerted effort to include a diverse patient population.
摘要：
目的：肛门鳞状细胞癌（SCC）患者接受保括约肌放疗和同步化疗，实现优异的肿瘤学结果。患者,然而,可能经历治疗相关的发病率，包括性功能障碍。本系统综述的目的是回顾有关接受肛门癌治疗的女性患者性功能障碍的文献，并确定知识差距。
方法：本系统评价在开始之前在PROSPERO注册。搜索的数据库包括MEDLINE，Embase,PubMed,科克伦,谷歌学者。对研究时间没有限制。研究仅限于英语。所有研究设计都包括在内，但评论文章除外，给编辑的信，以及少于10名患者的病例报告。
结果：总计，检索了1801项研究，其中19项符合纳入标准，包括:13项横断面调查，3前瞻性研究，1项纵向干预研究，1个回顾性图表审查，1例病例对照研究。使用女性性功能指数（FSFI）评估性功能，EORTC-QLQ-CR30和-CR38；反应率低（大多数研究<50％）。据报道，多达85％的女性出现性功能障碍；最常见的症状是性交困难（17-65％）。阴道干燥（22-88%），和性欲丧失（38-95％）。胃肠道问题,比如肠道问题，和身体形象的关注还影响性功能和生活质量。
结论：性功能障碍是影响大多数接受肛门癌治疗的女性患者的常见问题，并且缺乏处理这一重要生存问题的证据。此外，还缺乏种族，经济,和教育多样性，没有研究解决LGBTQ个体的独特需求-未来的研究应该共同努力，以包括多样化的患者人群。
方法：本系统评价在开始之前在PROSPERO注册。搜索的数据库包括MEDLINE，Embase,PubMed,科克伦,谷歌学者。对研究时间没有限制。研究仅限于英语。所有研究设计都包括在内，但评论文章除外，给编辑的信，以及少于10名患者的病例报告。
结果：总计，检索了1801项研究，其中19项符合纳入标准，包括:13项横断面调查，3前瞻性研究，1项纵向干预研究，1个回顾性图表审查，1例病例对照研究。使用女性性功能指数（FSFI）评估性功能，EORTC-QLQ-CR30和-CR38；反应率低（大多数研究<50％）。据报道，多达85％的女性出现性功能障碍；最常见的症状是性交困难（17-65％）。阴道干燥（22-88%），和性欲丧失（38-95％）。胃肠道问题,比如肠道问题，和身体形象的关注还影响性功能和生活质量。
结论：性功能障碍是影响大多数接受肛门癌治疗的女性患者的常见问题，并且缺乏处理这一重要生存问题的证据。此外，还缺乏种族，经济,和教育多样性，没有研究解决LGBTQ个体的独特需求-未来的研究应该共同努力，以包括多样化的患者人群。
