Combination of laser plus 5-fluorouracil for the treatment of extensive genital condylomata acuminata

• Published in: Lasers in surgery and medicine Vol. 8; no. 2; p. 135
• Main Author: Krebs, H B
• Format: Journal Article
• Language: English
• Published: United States 1988
• Subjects: Combined Modality Therapy; Condylomata Acuminata - drug therapy; Condylomata Acuminata - surgery; Condylomata Acuminata - therapy; Female; Fluorouracil - therapeutic use; Genital Neoplasms, Female - drug therapy; Genital Neoplasms, Female - surgery; Genital Neoplasms, Female - therapy; Humans; Laser Therapy
• ISSN: 0196-8092; 1096-9101
• DOI: 10.1002/lsm.1900080208

Although laser is effective in the treatment of genital condylomata, patients with extensive lesions frequently require more than one treatment. The present study was undertaken to investigate whether the cure rate achieved by a single laser treatment could be improved by adding topical 5% 5-fluorouracil (5-FU). Twenty patients with extensive genital condylomata were treated with laser alone. Twenty patients comparable to the first group in age, number, size, and distribution of the condylomata were treated by laser and 5-FU. The first application of 5% 5-FU cream was carried out at the end of the laser treatment by the surgeon in the operating room. The patients were instructed to apply 5-FU cream once weekly to the vulva and once every two weeks to the vagina by using an applicator filled to one-third with 5-FU cream. Seven patients (35%) without 5-FU were found to have persistent condylomata at the first follow-up examination eight to 12 weeks after the single laser treatment. Two additional patients were noted to have disease six and nine months after laser treatment. The combination of laser and 5-FU failed in two cases (10%), both identified at the first visit. The difference is statistically significant (P less than .025, chi-square test). Two patients exposed to 5-FU experienced chemical vulvitis. It is concluded that the combination of a single laser treatment and 5-FU has acceptable side effects and results in a higher cure rate than a single laser treatment without 5-FU.