Photodynamic therapy of cervical intraepithelial neoplasia 1-3 and human papilloma virus (HMV) infection with methylaminolevulinate and hexaminolevulinate--a double-blind, dose-finding study.
BACKGROUND
Cervical intraepithelial neoplasia (CIN) 1-3 is the precursor of invasive cervical cancer and associated with human papillomavirus infection. Standard treatment is surgical and may be associated with subsequent pregnancy complications. Photodynamic therapy (PDT) of CIN may be an interesting alternative.


METHODS
Patients were treated by PDT using hexaminolevulinate (HAL) and methylaminolevulinate in six dose and light groups and two incubation periods in a double-blind setting. Follow-up examinations were performed after 3, 6, and 12 months with histology, cytology, and HPV testing.


RESULTS
We included eight patients with CIN1, 23 with CIN2, and 36 with CIN3. Treatment was well tolerated. HAL 40 mM with 3-hour application turned out to be the most-effective group with 67% (10/15) complete response rate. The combined complete and partial response for patients with CIN2 was 83% (20/24).


CONCLUSIONS
PDT with CIN may be a safe and effective procedure for CIN treatment.
Department of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany. soergel.philipp@mh-hannover.de
Philipp
P
Soergel
Gunn Fallås
GF
Dahl
Mathias
M
Onsrud
Peter
P
Hillemanns
D000328:Adult; D000622:Aminolevulinic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000150:complications / Q000188:drug therapy*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000188:drug therapy* / Q000821:virology
D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid; C419924:5-aminolevulinic acid hexyl ester