title: Can photodynamic therapy be the preferred treatment option for anal intraepithelial neoplasia? Initial results of a pilot study.
abstract: Anal intra-epithelial neoplasia (AIN) is a pre-malignant condition, which over time may progress to invasive anal squamous cell carcinoma. There is no standard treatment for AIN, but one of the therapeutic options available is photodynamic therapy (PDT). There are very few published studies of the efficacy of PDT, but it has been shown to produce downgrading of high-grade dysplasia in the anal region. The aim of the study was to evaluate the role of PDT in the treatment of AIN. Fifteen patients who received anal PDT between 2004 and 2013 were identified; twelve of these had AIN, two had intra-epithelial adenocarcinoma and one had dysplasia with high-risk human papillomavirus. After a median follow-up of nineteen months, ten of these have had at least one follow-up with aceto-white staining. Six of these ten patients had a complete response to PDT, although three subsequently had some recurrence. Three further patients had a partial response to PDT. There were no major therapeutic complications. Our findings suggest that PDT is a safe and feasible treatment option for AIN, associated with reasonable response rates and relatively little morbidity. Further research into the efficacy of PDT for AIN is required.
authors.affiliation: Hull and East Yorkshire Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, United Kingdom. Electronic address: hannahwelbourn@doctors.org.uk.
authors.forename: Hannah
authors.initials: H
authors.lastname: Welbourn
authors.affiliation: Hull and East Yorkshire Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, United Kingdom; The Yorkshire Laser Centre, Goole and District Hospital, Woodlands Avenue, East Yorkshire, Goole DN14 6RX, United Kingdom.
authors.forename: Graeme
authors.initials: G
authors.lastname: Duthie
authors.affiliation: Hull and East Yorkshire Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Powell
authors.affiliation: Hull and East Yorkshire Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, United Kingdom; The Yorkshire Laser Centre, Goole and District Hospital, Woodlands Avenue, East Yorkshire, Goole DN14 6RX, United Kingdom.
authors.forename: Keyvan
authors.initials: K
authors.lastname: Moghissi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000188:drug therapy / Q000628:therapy*; D002278:Carcinoma in Situ / Q000188:drug therapy / Q000628:therapy*; D017323:Dihematoporphyrin Ether / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods; D017319:Photosensitizing Agents / Q000627:therapeutic use; D010789:Phototherapy / Q000379:methods*; D010865:Pilot Projects
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid; D017323:Dihematoporphyrin Ether
keywords: Anal intraepithelial neoplasia; Photodynamic therapy