Banca de QUALIFICAÇÃO: ANA CAROLINA ZIMMERMANN SIMÕES

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : ANA CAROLINA ZIMMERMANN SIMÕES
DATE: 11/09/2024
TIME: 13:00
LOCAL: Sala de Aulas II GEP/MEJC
TITLE:

Interventions for the treatment of vulvar high-grade squamous intraepithelial lesions: A systematic review

KEY WORDS:

HSIL, VIN, uVIN, dVIN, vHSIL, High-grade vulvar intraepithelial lesion

PAGES: 30
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

Objective: The main objective was to access efficiency of the treatments. Secondary outcome was to evaluate safety. Methods: This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol for this study was previously registered in the PROSPERO International Prospective Register of Systematic Reviews (registration number: CRD42023442818. A comprehensive search was performed across PubMed, Scopus, Web of Science, Embase and Cochrane Central Register of Controlled Trials were searched with no limitations to date of publication or language. All electronic databases were searched on February 5th, 2024. Randomized clinical trials that compared any form of treatment of vulvar intraepithelial lesions to placebo or other treatments were included. Data was stracted from the selected studies by two authors independently. The risk of bias was assessed using the Cochrane Risk of Bias (RoB 2.0) tool. RevMan 5.4. was used for data synthesis. The Grading of Recommendations Assessment Development (GRADE) and Evaluation method was used to assess the strength of the evidence. Results: A total of 10306 articles of which 7553 were duplicates. Of the remaining articles, 8 met inclusion criteria and were included in this review. Two studies compared imiquimod 5% to placebo, one to cidofovir 1% and one other to surgical procedures. One study compared CO2 vaporization to ultrasonic surgical aspiration. Only one study analyzed Sinecatechins 10% (Veregen®) and another Omiganan pentahydrochloride both compared to placebo. The natural compound indole-3- carbinol (I3C) was tested in two different dosages with no comparison to placebo or other treatment. Studies had a follow up range from 12 weeks to 12 months. Three studies had a low risk of bias, four were evaluated as having some concerns and one high risk of bias. In a 2007 Danish study by Matiesen et al., imiquimod showed significant effectiveness over placebo in treating lesions, with 17 of 21 women achieving complete regression, but with notable side effects. Van Seters et al. (2008) found that 35% of patients had complete lesion responses with imiquimod and 69% showed lesion grade regression. Tristan et al. (2014) compared imiquimod to cidofovir, finding 61% and 57% complete response rates, respectively. Trutnovsky et al. (2022) demonstrated the non-inferiority of imiquimod compared to surgical treatment, with 80% response in the imiquimod group. Yap (2020) found that sinecatechins were not more effective than placebo but showed improvement in lesion progression.

COMMITTEE MEMBERS:
Presidente - 1199080 - ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
Externo à Instituição - KLEYTON SANTOS DE MEDEIROS - LNRCC
Externa ao Programa - 4149590 - MARIA DE LOURDES COSTA DA SILVA - null