Photodynamic therapy for cervical intraepithelial neoplasia

Oncology. 2005;69(2):110-6. doi: 10.1159/000087812. Epub 2005 Aug 23.

Abstract

Objectives: Photodynamic therapy (PDT) is a minimally invasive treatment for cervical intraepithelial neoplasia (CIN). We report the effectiveness of PDT in 105 cases of CIN.

Methods: All patients received photofrin (PHE) 2 mg/kg intravenously and, 48-60 h later, phototherapy was performed using the Excimer dye laser or a YAG-OPO laser with an irradiation dose of 100 J/cm(2) using 630 nm wavelength.

Results: Mild photosensitivity occurred in 48% (50/105) of patients. The complete response (CR) rate was 90% (94/105) at 3 months following treatment. In the remaining 11 patients, 5 patients had CIN1, 2 patients had CIN2, and 4 patients had mild cytologic findings. However, in 9 of these 11 patients, CR was achieved 6 months after PDT. In 69 patients, human papilloma virus (HPV) typing was performed before and after PDT therapy. Pre-treatment, 64 of 69 patients (93%), were HPV-positive including 30 cases of high-risk HPV (43%). Testing performed 3, 6 and 12 months following PDT revealed no HPV-DNA in 75% (52/69), 74% (48/65) and 72% (41/57) of patients. At present, the median follow-up period is 636 days (90-2,232 days). In 3 patients, recurrence requiring surgical treatment was identified at 646, 717 and 895 days after PDT.

Conclusions: PDT is an effective and minimally invasive treatment for CIN, which also appears to eradicate HPV infection.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Dihematoporphyrin Ether / administration & dosage
  • Dihematoporphyrin Ether / adverse effects
  • Dihematoporphyrin Ether / therapeutic use*
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Papillomavirus Infections / complications
  • Photochemotherapy* / adverse effects
  • Photochemotherapy* / methods
  • Treatment Outcome
  • Uterine Cervical Dysplasia / drug therapy*
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Dysplasia / virology
  • Uterine Cervical Neoplasms / drug therapy*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / virology

Substances

  • Antineoplastic Agents
  • Dihematoporphyrin Ether