Photodynamic therapy for cervical intraepithelial neoplasia.
OBJECTIVE
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.
Yamaguchi
Satoshi
S
Department of Gynecology, Hyogo Medical Center for Adults, Akashi, Japan.
Tsuda
Hiroshi
H
Takemori
Masayuki
M
Nakata
Shinich
S
Nishimura
Sadako
S
Kawamura
Naoki
N
Hanioka
Keisuke
K
Inoue
Takeshi
T
Nishimura
Ryuichiro
R
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017323:Dihematoporphyrin Ether / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D030361:Papillomavirus Infections / Q000150:complications; D010778:Photochemotherapy / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000188:drug therapy* / Q000473:pathology / Q000821:virology
D000970:Antineoplastic Agents; D017323:Dihematoporphyrin Ether