ADJUVANT TREATMENT WITH RETINOIDS AND INTERFERON-ALPHA AFTER CO2-LASER SURGERY OF MULTICENTRIC INTRAEPITHELIAL NEOPLASIA OF THE UPPER GENITAL-TRACT

Objective: In patients with multifocal VIN we observe a high recurrenc e rate independent of the treatment method used. The adjuvant treatmen t with interferon alpha alone is mostly ineffective. In this case repo rt, we describe the effectiveness of an adjuvant treatment with a comb ination of isotretinoin and interferon alpha, done to a patient with r ecurrent multicentric intraepithelial neoplasia of the upper genital t ract after CO2-laser surgery. Method and material: The adjuvant medica l treatment with interferon alpha-2 a (Roferon A 4.5) and isotretinoin (Roaccutan) was done for eight weeks. Subcutaneous injections of inte rferon alpha-2a were given three times a week in a dosage of 4.5 mio. I. E. Roaccutan tablets were applied orally in a dosage of 1 mg/KG bod y weight once a day. During the period of medical treatment a gynaecol ogical examination was done every four weeks. Subsequently, gynaecolog ical examination was done every three months until now. Results: Durin g the eight-week treatment with interferon alpha and isotretinoin, the patient did not report real side effects. The last gynaecological exa mination was done thirteen months after the medical treatment. For mor e than one year the patient has been without recurrent disease to date . Conclusion: It has to be investigated whether adjuvant treatment wit h interferon alpha and isotretinoin decreases the recurrence rate in p atients with multicentric intraepithelial neoplasia of the lower genit al tract or in patients with multifocal VIN.