A single-center experience is presented on the use of 5-fluorouracil in the treatment of VAIN 2-3

Year 2024, Volume: 24 Issue: 1, 7 - 12, 30.04.2024

Yunus İlhan , Tuğçe Sırma , Nuri Yıldırım , Levent Akman , Cosan Terek , Firuze Beste Çelen , Zeycan Hacıoğlu , Gürdeniz Serin , Lena Türeyici , Aydın Özsaran

Abstract

Aim: Vaginal intraepithelial neoplasia (VAIN) has an average incidence of 0.2-0.3 per 100,000 women, which is much rarer than cervical intraepithelial neoplasia (CIN). It is mostly observed in the postmenopausal group.
Material and Method: The study included 46 patients who were histopathologically diagnosed as VAIN 2-3 and initiated topical 5-fluorouracil treatment with the decision of the multidisciplinary council between October 2014 and December 2022, following the approval of the local ethics committee. Five patients with invasive vaginal cancer or cervical cancer involving the vagina were excluded.
Results: The mean follow-up period was 32 months. Regression developed in 21 patients (51.2%), persistence in 15 (36.5%) and recurrence in 5 (12%). There were no patients with pregression.
Conclusion: This study demonstrated the 51.2% success rate of intravaginal 5-fluorouracil treatment of women with high-grade vaginal intraepithelial neoplasia. It is recommended for the treatment of VAIN 2-3 due to its minimal side effects, low cost, and reasonable cure rate.

Keywords

VAIN, 5-florourasil, HPV, CIN

VAIN 2-3 tedavisinde 5-florourasil kullanımı, tek merkez deneyimi

Abstract

Amaç: Vajinal intraepitelyal neoplazi (VAIN), ortalama 100 bin kadında 0,2-0,3 insidansa sahip olup servikal intraepitelyal neoplazi’ye (CIN) göre oldukça nadirdir. Çoğunlukla postmenopozal grupta izlenmektedir.
Gereç ve Yöntem: Çalışmaya yerel etik kurul onayı alındıktan sonra Ekim 2014 – Aralık 2022 tarihleri arasında histopatolojik olarak VAIN 2-3 tanısı almış ve multidisipliner konsey kararı ile topikal 5-florourasil tedavisi başlanmış 46 hasta dahil edilmiştir. İnvaziv vajinal kanser ya da vajeni tutmuş servikal kanserli 5 hasta çalışma dışına çıkarılmıştır.
Bulgular: Ortalama takip periyodu 32 aydı. Hastaların 21’inde (%51,2) regresyon gelişirken 15’inde (%36,5) persistans, 5’inde (%12) nüks gelişti. Pregresyon gösteren hasta yoktu.
Sonuç: Bu çalışma, yüksek dereceli vajinal intraepitelyal neoplazi tanısı olan kadınların intravajinal 5-florourasil ile tedavisinin, %51,2 lik başarısını göstermektedir. Minimal yan etkilere sahip, ucuz olup makul bir iyileşme oranı sunmasıyla VAIN 2-3 tedavisinde göz önünde bulundurulmalıdır.

Keywords

VAIN, 5-florourasil, HPV, CIN

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