Successful photodynamic therapy with topical 5-aminolevulinic acid for five cases of cervical intraepithelial neoplasia.
OBJECTIVE
Photodynamic therapy (PDT) is a minimally invasive treatment for cervical intraepithelial neoplasia. The purpose of this study was to assess the feasibility and effectiveness of PDT in patients with CIN and high-risk HPV infection.


METHODS
Five patients diagnosed CIN 2 or CIN 3 with human papillomavirus (HPV) infection were included. Each patient had gynecologic examination including cervical cytology, HPV DNA testing, colposcopy and biopsy. Two grams of 5-aminolevulinic acid (ALA) gel (118 mg/g) was topically applied to the cervix and covered with a special plastic cap for 3-4 h, followed by 20 min illumination of both ecto- and endo-cervical canal with red coherent light (wavelength 633 nm) using a PDT laser and a special light catheter. The PDT therapy was repeated with an interval of 1 week. Follow-up examination including biopsy and histology, colposcopy, HPV DNA testing were carried out after 3, 6 and 9 months.


RESULTS
Treatment could be accomplished in all cases and no severe side effect was encountered. All the CIN2 patients had a complete response for 9 months and one CIN3 HPV remained positive for 6 months after three or four treatments.


CONCLUSIONS
PDT seems to be a non-invasive, repeatable procedure for CIN and cervical HPV infection with minimal side effects and can be easily performed on outpatient basis.
Wang
Jing
J
Department of Dermatology, The Fourth People's Hospital of Shenzhen (Futian People's Hospital), Shenzhen, China. jwangray@163.net
Xu
Juan
J
Chen
Jiayuan
J
He
Qin
Q
Xiang
Li
L
Huang
Xiameng
X
Ding
Guirong
G
Xu
Shengmei
S
D000287:Administration, Topical; D000328:Adult; D000622:Aminolevulinic Acid / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000188:drug therapy*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000188:drug therapy* / Q000473:pathology / Q000821:virology
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid