Phenol-based Chemical Peeling Therapy for Cervico-vaginal Intraepithelial Neoplasia (CIN/VaIN)

Abstract

Objective:
 This study aimed to validate the use of liquid phenol-based chemical peeling therapy for cervico-vaginal intraepithelial neoplasia (CIN and VaIN), with the goal of circumventing obstetric complications associated with surgical treatment.
 
 Methods: 
 A total of 483 eligible women diagnosed with CIN and/or VaIN participated in this study. Participants underwent phenol-based chemical peeling therapy every 4 weeks until disease clearance. Disease clearance was determined by negative Pap tests for four consecutive weeks. HPV genotyping was conducted at the onset of the study and after disease clearance in select cases. 
 
 Results:
 Among the 476 participants (excluding those with cancer), the number of treatment sessions until CIN/VaIN clearance ranged from 2 to 49 (median = 7 sessions). Forty-five participants (9.4%) underwent surgical treatments. Seven participants (1.5%) experienced recurrence, presenting with CIN2/VaIN2 or worse lesions; of these, three underwent LEEP, while four repeated the chemical peeling therapy. No obstetrical complications were noted among the 98 pregnancies following this therapy. The findings suggest that phenol-based therapy is safe and effective for CIN, although it requires numerous and lengthy treatments. Factors associated with resistance to this therapy include immune suppression, high-grade lesions, multiple HPV type infection, and direct or passive smoking.