Treatment of CIN with the CO2 laser vaporization.

A group of two hundred and sixty women, most of them young, with histologic diagnosis of CIN located at the exocervix, has been treated by means of CO2 laser vaporization. The entire transformation zone and a minimum of 10 mm at the base of cervical canal was vaporized to a depth of 6-7 mm. Of the treated group, 239 patients (114 CIN I, 78 SIN II and 47 CIN III), were followed for a mean of 19 months. The failure rate of a single treatment was 8.8% for CIN I, 11.5% for CIN II and 12.7% for CIN III. These results are in agreement with world Literature The majority of failures, diagnosed within the first year of follow-up were small areas of CIN I-II located around the squamo-columnar junction, and only two CIN III were detected. No evidence of CIN was observed after a second treatment. No case of invasive cancer has been detected. Fertility was not affected by the treatment. It is concluded that CO2 laser vaporization is a safe and effective method for treatment of CIN. Patient selection, proper technique, close follow-up and adequate treatment of failures are essential to this end.

Intraarterial infusion chemotherapy as a primary treatment in cancer of uterine cervix limited to the pelvis.

Percutaneous intraarterial infusion chemotherapy via the internal iliac arteries was performed as a primary treatment in 14 patients with invasive cancer of the uterine cervix. The drugs used were Mitomycin-C, Bleomycin and Cis-Platinum in cycles of 52 hours which were repeated, in some cases, 21 days apart. Complete responses were observed in two patients. Partial responses were seen in 10 patients and no response in two patients. 5 patients were treated surgically and 8 patients received radiotherapy after the infusion. The effect of chemotherapy was more evident in exophytic tumors with less effect on the parametria. Tumor masses can be reduced and patients can then be treated by surgery or radiotherapy. 6 patients died from sepsis.