High-dose-rate brachytherapy in the management of high-grade intraepithelial neoplasia of the vagina

Gynecol Oncol. 1997 Apr;65(1):74-7. doi: 10.1006/gyno.1996.4608.


The majority of women with high-grade intraepithelial neoplasia (VAIN 3) are over 60 years of age and have a history of premalignant or malignant disease of the cervix. Although the natural history of VAIN is not well defined, high-grade lesions are premalignant. Ablative treatment with laser or 5-fluorouracil cream is commonly unsatisfactory. Several series have reported a low rate of recurrence and complications if VAIN 3 is treated with low-dose-rate brachytherapy. This retrospective review reports the outcome of 14 patients treated with high-dose-rate brachytherapy, with a dose of 34 to 45 Gy in 4.5- to 8.5-Gy fractions. Treatment was well tolerated with no severe early or late toxicity observed. At a median follow-up of 46 months 1 patient progressed to invasive carcinoma of the vagina; in another patient VAIN 3 persisted.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brachytherapy / adverse effects
  • Brachytherapy / methods
  • Brachytherapy / standards*
  • Carcinoma in Situ / radiotherapy*
  • Carcinoma in Situ / surgery
  • Combined Modality Therapy
  • Dose-Response Relationship, Radiation
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Treatment Outcome
  • Vaginal Neoplasms / radiotherapy*
  • Vaginal Neoplasms / surgery