Laser and radiofrequency for treating genitourinary syndrome of menopause in breast cancer survivors: A systematic review of randomized controlled trial.

backgroundBreast cancer survivors (BCS) often experience more severe symptoms of genitourinary syndrome of menopause (GSM). As estrogen-based hormonal therapy is generally avoided in BCS, physical energy methods may offer promising non-hormonal alternatives. However, the efficacy and safety of these treatments remain controversial.

objectivesTo evaluate the efficacy and safety of physical energy methods (laser and radiofrequency) for treating GSM in BCS. SEARCH STRATEGY: The databases PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, SciELO, LILACS, and Clinical Trial databases were searched from their inception to July 2024, with no language restrictions. SELECTION CRITERIA: We included randomized controlled trials (RCTs) that assessed the efficacy and safety of any physical energy methods for treating GSM in BCS. DATA COLLECTION AND ANALYSIS: Two authors independently selected studies based on titles, abstracts, and full texts to meet the inclusion criteria. Due to heterogeneity in methodologies and outcomes, a meta-analysis was not possible, so a narrative synthesis was conducted. Data were extracted, and the risk of bias was assessed using the Cochrane risk-of-bias tool (RoB 2). The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to assess the strength of the evidence. MAIN

resultsThree RCTs involving 185 participants, and three different physical methods (microablative fractional CO

conclusionsPhysical energy methods show short-term safety in treating GSM in BCS. However, limited blinded clinical trials result in uncertain efficacy.