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Journal of Lower Genital Tract Disease:
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Effectiveness of 5-Fluorouracil in the Treatment of Vaginal Intraepithelial Neoplasia in a Mexican Population.

Gonzalez-Sanchez, Jose Luis MD; Flores-Murrieta, Guadalupe MD; Deolarte-Melgarejo, Jose Mauricio MD; Rios-Montiel, Fernando Alfonso MD; Hernandez-Manzano, Alejandro MD

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Objective. Our purpose was to determine the effectiveness of 5-fluorouracil (5-FU) in the treatment of vaginal intraepithelial neoplasia (VaIN) in a Mexican population.

Materials and Methods. The study was performed in 30 patients with a mean age of 54 years and previous diagnoses from reviewed records and histopathology slides selected from a group of 65 patients with VaIN from 1980 to 1997. Patients received intravaginal treatment with 5-FU, 1.5 g once weekly for 10 weeks, and all patients were followed up for a 1-year minimum. Papanicolaou smear and colposcopy were performed, as was biopsy when indicated.

Results. Twenty-eight (93%) patients with VaIN had prior or concurrent anogenital squamous neoplasia, including 5 with invasive cervical carcinoma and 23 with cervical intraepithelial neoplasia. In 23 of 30 treated patients (77%), VaIN went into remission after a single treatment; in 3, (10%), it went into remission after two treatments; 3 (10%) had recurrent VaIN 3; and in 1 (3%), it progressed to invasive vaginal cancer. The treatment was well tolerated.

Conclusions. We conclude that 5-FU is an option choice for VaIN treatment. It is effective, with minimal side effects. Its use should be confined to treating extensive or multifocal high-grade VaIN.

(C)1998The American Society for Colposcopy and Cervical Pathology


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