5-aminolevulinic acid-mediated photodynamic therapy of intraepithelial neoplasia and human papillomavirus of the uterine cervix--a new experimental approach.
The aim of this study was to treat patients for ectocervical dysplasia [cervical intraepithelial neoplasia (CIN) grades 1 and 2] and associated human papilloma virus (HPV) infections with photodynamic therapy (PDT). In 20 patients, 5-aminolevulinic acid (5-ALA, 12% w/v) was applied topically with a cervical cap 8 h prior to illumination. A thermal light source (150 W halogen lamp) emitting a broadband red light (total energy: 100 J/cm2, fluence rate: 90 mW/cm2) was used for superficial illumination of the portio. In addition, an Nd:YAG pumped dye laser (652 nm) was used to illuminate the cervical canal (total energy: 50 J/cm2, fluence rate: 300 mW/cm2). Preliminary results of follow-ups at 1, 3, 6, and 9 months posttherapy showed a cytological improvement in the grading of the PAP smears in 19 patients and the eradication of cervical HPV in 80%. These results demonstrate that ectocervical dysplasia and associated HPV infections can be treated by PDT.
Department of Obstetrics and Gynecology, Rudolfstiftung Hospital, Vienna, Austria.
F
F
Wierrani
A
A
Kubin
R
R
Jindra
M
M
Henry
K
K
Gharehbaghi
W
W
Grin
J
J
Söltz-Szötz
G
G
Alth
W
W
Grünberger
D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D000622:Aminolevulinic Acid / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications / Q000188:drug therapy*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D016896:Treatment Outcome; D014412:Tumor Virus Infections / Q000150:complications / Q000188:drug therapy*; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000188:drug therapy*; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000188:drug therapy*
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid