Low Dose 5-Fluorouracil Intravaginal Therapy for the Treatment of Cervical Intraepithelial Neoplasia 2/3: A Case Series

Abstract

Objective:

There are no currently approved options for medical management of cervical intraepithelial neoplasia (CIN) 2/3. This article describes the use of intravaginal 5% 5-fluorouracil (5-FU) for treatment of CIN 2/3.

Materials and Methods:

This retrospective case-series describes 25 women who used low-dose intravaginal 5-FU (2 g once every 2 weeks for 8 doses) between January 1, 2014, and July 30, 2018, for the following indications: primary therapy (CIN 2/3 present on colposcopic biopsy); adjuvant therapy (positive margins after excisional procedure); or neoadjuvant therapy (excision delayed due to severe immunodeficiency). Descriptive analyses were performed.

Results:

Within the 12-month follow-up period, 16 women (64%) of women had regression to CIN 1 or normal histology after use of low dose 5-FU. Seven of the 8 who did not regress reported completing < 4 of the 8 recommended doses of 5-FU. Six women discontinued 5-FU treatment: 2 due to allergy, 3 due to self-resolving local side-effects, and 1 due to desire to stop contraception.

Conclusions:

Based on this study, there is patient interest and potential efficacy in alternatives to conventional management of CIN. The use of intravaginal therapies for treatment of CIN 2/3 merits further study.