title: Treatment of vulvar intraepithelial neoplasia with topical 5% imiquimod cream.
abstract: OBJECTIVE
  To assess the efficacy of 5% imiquimod cream for treating vulvar intraepithelial neoplasia (VIN).
  
  
  METHODS
  In a retrospective study, data were analyzed from 62 patients with biopsy-diagnosed VIN stage I-III who were treated with 5% imiquimod cream at University Hospital of Freiburg, Germany, between 2004 and 2011. Several patient and lesion characteristics were evaluated, and follow-up was 3-72 months (median 21 months).
  
  
  RESULTS
  Among 62 women treated, 47 (76%) showed a complete response, 12 (19%) showed a partial response, 2 (3%) showed a weak partial response, and 1 did not respond. Disease recurrence occurred for 17 (27%) women. Recurrence rates were significantly lower among HPV-positive patients (P=0.046), and among women younger than 65 years (P=0.030). Patients without local inflammation during treatment were less likely to show a complete response (P=0.049). Response rates did not depend on lesion size; however, women with large lesions required longer treatment and higher total dosages for a complete response.
  
  
  CONCLUSIONS
  5% imiquimod cream was found to be a favorable alternative to ablative treatment of VIN independently of lesion grading, appearance, and size. Patient age, HPV status, and occurrence of adverse effects significantly influenced treatment outcome.
authors.affiliation: Division of Gynecology and Obstetrics, University of Freiburg, Freiburg, Germany. claudia.westermann@googlemail.com
authors.forename: Claudia
authors.initials: C
authors.lastname: Westermann
authors.forename: Anna
authors.initials: A
authors.lastname: Fischer
authors.forename: Andreas
authors.initials: A
authors.lastname: Clad
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000634:Aminoquinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D052162:Human papillomavirus 16; D006801:Humans; D000077271:Imiquimod; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D030361:Papillomavirus Infections / Q000150:complications / Q000821:virology; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D014622:Vaginal Creams, Foams, and Jellies; D014846:Vulvar Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000634:Aminoquinolines; D000970:Antineoplastic Agents; D014622:Vaginal Creams, Foams, and Jellies; D000077271:Imiquimod