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Rotar IC, Boitor Borza D, Staicu A, Goidescu IG, Nemeti GI, Iulia P, Mitranovici MI, Daniel M, Aida P. The Role of Medical Therapies in the Management of Cervical Intraepithelial Neoplasia: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:326. [PMID: 40005442 PMCID: PMC11857687 DOI: 10.3390/medicina61020326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Revised: 02/06/2025] [Accepted: 02/11/2025] [Indexed: 02/27/2025]
Abstract
Cervical cancer and its precursors (cervical intraepithelial neoplasia (CIN)) represent a current major public health concern. Currently, the treatment of choice for patients with HSILs (high-grade intraepithelial lesions) is surgical treatment-LEEP or cold-knife conization-except for in pregnant women, where it may have significant future consequences. In this paper, we aim to review the current evidence regarding the efficacy of non-surgical approaches for CINs. Therefore, we searched Google Scholar and PubMed for papers on CIN treatments; 91 studies published in English were included in the analysis. The results of the reviewed studies were variable depending on the agent and methodology used. Overall, the remission rates of CIN II ranged from 43 to 93%. However, for some agents, the results were contradictory. Once topical agents have been proven to be effective, they could be used as an alternative to surgical methods in treating HPV-associated CIN, with fewer adverse effects. The use of local agents could allow for more personalized treatments for patients with CINs. Future directions were also sought.
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Affiliation(s)
- Ioana Cristina Rotar
- Obstetrics and Gynecology I, Mother and Child Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.C.R.); (D.B.B.); (I.G.G.); (G.I.N.); (P.I.); (M.D.)
| | - Dan Boitor Borza
- Obstetrics and Gynecology I, Mother and Child Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.C.R.); (D.B.B.); (I.G.G.); (G.I.N.); (P.I.); (M.D.)
| | - Adelina Staicu
- Obstetrics and Gynecology I, Mother and Child Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.C.R.); (D.B.B.); (I.G.G.); (G.I.N.); (P.I.); (M.D.)
| | - Iulian Gabriel Goidescu
- Obstetrics and Gynecology I, Mother and Child Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.C.R.); (D.B.B.); (I.G.G.); (G.I.N.); (P.I.); (M.D.)
| | - Georgiana Irina Nemeti
- Obstetrics and Gynecology I, Mother and Child Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.C.R.); (D.B.B.); (I.G.G.); (G.I.N.); (P.I.); (M.D.)
| | - Popa Iulia
- Obstetrics and Gynecology I, Mother and Child Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.C.R.); (D.B.B.); (I.G.G.); (G.I.N.); (P.I.); (M.D.)
| | - Melinda Ildiko Mitranovici
- Department of Obstetrics and Gynecology, Emergency County Hospital Hunedoara, 14 Victoriei Street, 331057 Hunedoara, Romania
| | - Mureșan Daniel
- Obstetrics and Gynecology I, Mother and Child Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.C.R.); (D.B.B.); (I.G.G.); (G.I.N.); (P.I.); (M.D.)
| | - Petca Aida
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania;
- Department of Obstetrics and Gynecology, Elias University Emergency Hospital, 17 Mărăști Blvd., 050474 Bucharest, Romania
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Maocha I, Rosado B, Lopes-Nunes J, Lopes M, Rolo J, Pires B, Gallardo E, Palmeira-de-Oliveira A, Martinez-de-Oliveira J, Palmeira de Oliveira R, Medeiros R, Cruz C. Imiquimod-Loaded Nanosystem for Treatment Human Papillomavirus-Induced Lesions. Pharmaceutics 2024; 16:864. [PMID: 39065561 PMCID: PMC11279553 DOI: 10.3390/pharmaceutics16070864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/24/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
Human papillomavirus (HPV)-associated cervical cancer is the most common cancer among women worldwide. The treatment options are strongly related to increased infertility in women. Imiquimod (IQ) is an imidazoquinoline, which has proven antiviral effects against persistent HPV infection by activating immune cells via Toll-like receptors 7/8 when formulated in carriers, like nanogels, for topical use. An effective alternative to conventional therapies is the nanoparticle drug delivery system. We studied lipidic nanoparticles with IQ (Lipo IQ) and functionalized them with a DNA aptamer, AT11 (Lipo IQ AT11), to improve the selectivity for cervical cancer cells combined with the efficacy of essential oils. The formulations showed that the physicochemical properties are adequate for vaginal drug delivery and have antimicrobial activity at higher concentrations (with MIC50 starting from 0.625%). The final formulations exhibited cytotoxicity in cancer cells, enhanced by essential oils without affecting healthy cells, resulting in less than 10% cell viability in HeLa cells and over 60% in NHDF cells. Essential oils potentiate Lipo IQ's effectiveness, while AT11 increases the selectivity for cervical cancer cells. As suggested by the results of the permeation assay, the formulations were internalized by the cancer cells. Overall, the obtained results suggested that the synergistic effect of the essential oils and the nanosystem potentiate the cytotoxic effect of Lipo IQ and that Lipo IQ AT11 promotes selectivity towards cancer cells.
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Affiliation(s)
- Izamara Maocha
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal; (I.M.); (B.R.); (J.L.-N.); (M.L.); (J.R.); (B.P.); (E.G.); (A.P.-d.-O.); (J.M.-d.-O.); (R.P.d.O.)
| | - Beatriz Rosado
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal; (I.M.); (B.R.); (J.L.-N.); (M.L.); (J.R.); (B.P.); (E.G.); (A.P.-d.-O.); (J.M.-d.-O.); (R.P.d.O.)
| | - Jéssica Lopes-Nunes
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal; (I.M.); (B.R.); (J.L.-N.); (M.L.); (J.R.); (B.P.); (E.G.); (A.P.-d.-O.); (J.M.-d.-O.); (R.P.d.O.)
| | - Melanie Lopes
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal; (I.M.); (B.R.); (J.L.-N.); (M.L.); (J.R.); (B.P.); (E.G.); (A.P.-d.-O.); (J.M.-d.-O.); (R.P.d.O.)
| | - Joana Rolo
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal; (I.M.); (B.R.); (J.L.-N.); (M.L.); (J.R.); (B.P.); (E.G.); (A.P.-d.-O.); (J.M.-d.-O.); (R.P.d.O.)
| | - Bruno Pires
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal; (I.M.); (B.R.); (J.L.-N.); (M.L.); (J.R.); (B.P.); (E.G.); (A.P.-d.-O.); (J.M.-d.-O.); (R.P.d.O.)
| | - Eugénia Gallardo
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal; (I.M.); (B.R.); (J.L.-N.); (M.L.); (J.R.); (B.P.); (E.G.); (A.P.-d.-O.); (J.M.-d.-O.); (R.P.d.O.)
| | - Ana Palmeira-de-Oliveira
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal; (I.M.); (B.R.); (J.L.-N.); (M.L.); (J.R.); (B.P.); (E.G.); (A.P.-d.-O.); (J.M.-d.-O.); (R.P.d.O.)
- Labfit–Health Products Research and Development Lda, UBIMedical, 6200-284 Covilhã, Portugal
- Faculty of Health Sciences, University of Beira Interior, 6200-506 Covilhã, Portugal
| | - José Martinez-de-Oliveira
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal; (I.M.); (B.R.); (J.L.-N.); (M.L.); (J.R.); (B.P.); (E.G.); (A.P.-d.-O.); (J.M.-d.-O.); (R.P.d.O.)
| | - Rita Palmeira de Oliveira
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal; (I.M.); (B.R.); (J.L.-N.); (M.L.); (J.R.); (B.P.); (E.G.); (A.P.-d.-O.); (J.M.-d.-O.); (R.P.d.O.)
- Labfit–Health Products Research and Development Lda, UBIMedical, 6200-284 Covilhã, Portugal
- Faculty of Health Sciences, University of Beira Interior, 6200-506 Covilhã, Portugal
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC) Raquel Seruca, 4200-072 Porto, Portugal;
- Faculty of Medicine, University of Porto (FMUP), 4200-319 Porto, Portugal
| | - Carla Cruz
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal; (I.M.); (B.R.); (J.L.-N.); (M.L.); (J.R.); (B.P.); (E.G.); (A.P.-d.-O.); (J.M.-d.-O.); (R.P.d.O.)
- Departamento de Química, Universidade da Beira Interior, 6201-001 Covilhã, Portugal
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Abd Rashid N, Mohamad Najib NH, Abdul Jalil NA, Teoh SL. Essential Oils in Cervical Cancer: Narrative Review on Current Insights and Future Prospects. Antioxidants (Basel) 2023; 12:2109. [PMID: 38136228 PMCID: PMC10740549 DOI: 10.3390/antiox12122109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/05/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023] Open
Abstract
Cervical cancer is a prevalent and often devastating disease affecting women worldwide. Traditional treatment modalities such as surgery, chemotherapy, and radiation therapy have significantly improved survival rates, but they are often accompanied by side effects and challenges that can impact a patient's quality of life. In recent years, the integration of essential oils into the management of cervical cancer has gained attention. This review provides an in-depth exploration of the role of various essential oils in cervical cancer, offering insights into their potential benefits and the existing body of research. The review also delves into future directions and challenges in this emerging field, emphasizing promising research areas and advanced delivery systems. The encapsulation of essential oils with solid lipid nanoparticles, nanoemulsification of essential oils, or the combination of essential oils with conventional treatments showed promising results by increasing the anticancer properties of essential oils. As the use of essential oils in cervical cancer treatment or management evolves, this review aims to provide a comprehensive perspective, balancing the potential of these natural remedies with the challenges and considerations that need to be addressed.
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Affiliation(s)
- Norhashima Abd Rashid
- Department of Biomedical Science, Faculty of Applied Science, Lincoln University College, Petaling Jaya 47301, Malaysia;
| | - Nor Haliza Mohamad Najib
- Unit of Anatomy, Faculty Medicine & Health Defence, Universiti Pertahanan Nasional Malaysia, Kuala Lumpur 57000, Malaysia;
| | - Nahdia Afiifah Abdul Jalil
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Seong Lin Teoh
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
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Stuopelytė R, Žukienė G, Breivienė R, Rudaitis V, Bartkevičienė D. Quality of Life in Cervical Cancer Survivors Treated with Concurrent Chemoradiotherapy. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040777. [PMID: 37109735 PMCID: PMC10141383 DOI: 10.3390/medicina59040777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/31/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: Cervical cancer is the fourth most common cancer in women globally. As survival rates gradually increase, it becomes necessary to assess the quality of life (QoL) after treatment. It is known that different treatment modalities have different effects on QoL. Therefore, we aimed to evaluate the QoL of cervical cancer survivors (CCSs) treated with concurrent chemoradiotherapy (CCRT). Materials and Methods: A cross-sectional monocentric study, conducted in Vilnius university hospital Santaros klinikos between November 2018 and November 2022, included 20 women, who were interviewed once using the European Organization for Research and Treatment of Cancer (EORTC)-designed Quality-of-Life questionnaire cervical cancer module (QLQ-CX24). The sociodemographic and clinical data as well as the results of the questionnaire are presented in mean, standard deviation and percentages. The QoL scores were compared between different age and stage groups using the Mann-Whitney U test. Results: Twenty participants, aged from 27 to 55 years, with a mean age of 44 years (SD = 7.6) participated in the study. All the participants were CCSs with an International Federation of Gynecology and Obstetrics (FIGO) stage from IB to IIIB and all of them were treated with CCRT. The symptom experience was relatively low and revealed a good result (21.8, SD = 10.2). Mean scores on body image, sexual/vaginal functioning, menopausal symptoms and sexual worry scales indicated moderate functioning and a moderate level of some of the cervical cancer specific symptoms after CCRT. Sexual activity and sexual enjoyment of the CCSs were low (11.7 (SD = 16.3), 14.3 (SD = 17.8), respectively). Conclusions: Cervical cancer survivors report a relatively good quality of life regarding symptom experience; however, women following concurrent chemoradiotherapy tend not to be sexually active and rarely feel sexual enjoyment. In addition, this treatment modality negatively affects a woman's body image and self-perception as a woman.
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Affiliation(s)
- Raminta Stuopelytė
- Faculty of Medicine, Vilnius University, M.K. Ciurlionio Str. 21, LT-03101 Vilnius, Lithuania
| | - Guoda Žukienė
- Clinic of Obstetrics and Gynaecology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Santariskiu Str. 2, LT-03101 Vilnius, Lithuania
| | - Rūta Breivienė
- Clinic of Obstetrics and Gynaecology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Santariskiu Str. 2, LT-03101 Vilnius, Lithuania
| | - Vilius Rudaitis
- Clinic of Obstetrics and Gynaecology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Santariskiu Str. 2, LT-03101 Vilnius, Lithuania
| | - Daiva Bartkevičienė
- Clinic of Obstetrics and Gynaecology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Santariskiu Str. 2, LT-03101 Vilnius, Lithuania
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Cancer Mechanisms and Emerging Therapies. Pharmaceutics 2021; 13:pharmaceutics13071045. [PMID: 34371736 PMCID: PMC8308996 DOI: 10.3390/pharmaceutics13071045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 11/21/2022] Open
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