Τίτλος:
Efficacy of 5% imiquimod for the treatment of Vaginal intraepithelial neoplasia—A systematic review of the literature and a meta-analysis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Vaginal intraepithelial neoplasia (VaIN) is an uncommon disease associated with HPV and is considered to be a precursor of vaginal carcinoma. To date, treatment recommendations vary with no universally accepted standard of care as best treatment modality. Nevertheless, 5% imiquimod appears to be a promising, alternative, non-invasive treatment option. To ascertain the efficacy of 5% imiquimod for the treatment of this rare condition, we conducted a systematic review and meta-analysis of the proportion of women who received 5% imiquimod with their complete response, HPV clearance and recurrence rates. A literature search was carried out throughout the PubMed, EMBASE, ClinicalTrials.gov and Cochrane Databases for relevant studies. We computed the summary proportions for complete response, HPV clearance and non-recurrence following administration of 5% imiquimod by random effects meta-analysis. Six articles reporting on 94 patients were included. The summary proportions of women with complete response and HPV clearance were 76.5% (95% CI 59.4–98.5) and 52.5% (95% CI 29.5–93.6) respectively. The summary proportion of women with non-recurrence appeared high (94.3% (95% CI 67.1–132)), yet not significant. Use of 5% imiquimod for the treatment of VaIN is associated with relatively high response rate, satisfactory HPV clearance, whilst the risk for VaIN recurrence appears low. © 2017
Συγγραφείς:
Tranoulis, A.
Laios, A.
Mitsopoulos, V.
Lutchman-Singh, K.
Thomakos, N.
Περιοδικό:
European Journal of Obstetrics and Gynecology and Reproductive Biology
Εκδότης:
Elsevier Ireland Ltd
Λέξεις-κλειδιά:
imiquimod; aminoquinoline derivative; antineoplastic agent; imiquimod, abdominal pain; application site excoriation; cancer recurrence; cancer therapy; Cochrane Library; diarrhea; drug efficacy; drug withdrawal; Embase; female; fever; flu like syndrome; health care quality; human; Medline; meta analysis; non invasive procedure; priority journal; randomized controlled trial (topic); recurrence risk; Review; systematic review; tumor diagnosis; vaginal intraepithelial neoplasia; viral clearance; adult; intravaginal drug administration; papillomavirus infection; retrospective study; treatment outcome; uterine cervix carcinoma in situ; vagina tumor; virology; young adult, Administration, Intravaginal; Adult; Aminoquinolines; Antineoplastic Agents; Cervical Intraepithelial Neoplasia; Female; Humans; Papillomavirus Infections; Randomized Controlled Trials as Topic; Retrospective Studies; Treatment Outcome; Vaginal Neoplasms; Young Adult
DOI:
10.1016/j.ejogrb.2017.09.020
