多中心随机 SPARC 试验评估了护士主导的性康复干预对妇科癌症放射治疗后性功能、痛苦、扩张器使用和阴道症状的疗效。符合条件的女性被随机分配接受康复干预或照常护理。在 12 个月内安排了四次干预会议，同时进行了经过验证的问卷和临床评估。主要结果是女性性功能指数（FSFI）。广义混合效应模型随时间推移对各组进行比较。总共包括 229 名女性（n = 112 名干预；n = 117 名照常护理）。在任何时间点，各组之间的 FSFI 总评分均未发现差异（P = 0.37），12 个月的评分为 22.57（干预）与 21.76（照常护理）。与常规护理相比，干预措施并未显着改善扩张器的使用，减少性痛苦或阴道症状。 12 个月时，医生报告两组患者的阴道狭窄程度都很轻。 70% 的女性性生活活跃，并且没有报告或有轻微的阴道症状。放疗和近距离放射治疗后，85%（干预）和 75%（照常护理）的参与者报告每周扩张两次。在 SPARC 试验之前和期间，接受（化疗）放射治疗和近距离放射治疗联合治疗的女性的性康复有所改善，这可能为可比较的研究小组做出了贡献。最佳实践包括放疗后 1 个月进行性康复预约，包括患者信息、扩张器指导（最好由经过培训的护士进行），以及治疗后第一年的随访。NCT03611517.© 2024。作者。

The multicentre randomised SPARC trial evaluated the efficacy of a nurse-led sexual rehabilitation intervention on sexual functioning, distress, dilator use, and vaginal symptoms after radiotherapy for gynaecological cancers.Eligible women were randomised to the rehabilitation intervention or care-as-usual. Four intervention sessions were scheduled over 12 months, with concurrent validated questionnaires and clinical assessments. Primary outcome was the Female Sexual Function Index (FSFI). A generalised-mixed-effects model compared groups over time.In total, 229 women were included (n = 112 intervention; n = 117 care-as-usual). No differences in FSFI total scores were found between groups at any timepoint (P = 0.37), with 12-month scores of 22.57 (intervention) versus 21.76 (care-as-usual). The intervention did not significantly improve dilator use, reduce sexual distress or vaginal symptoms compared to care-as-usual. At 12 months, both groups had minimal physician-reported vaginal stenosis; 70% of women were sexually active and reported no or mild vaginal symptoms. After radiotherapy and brachytherapy, 85% (intervention) versus 75% (care-as-usual) of participants reported dilation twice weekly.Sexual rehabilitation for women treated with combined (chemo)radiotherapy and brachytherapy improved before and during the SPARC trial, which likely contributed to comparable study groups. Best practice involves a sexual rehabilitation appointment 1 month post-radiotherapy, including patient information, with dilator guidance, preferably by a trained nurse, and follow-up during the first year after treatment.NCT03611517.© 2024. The Author(s).