title: Topical hexaminolevulinate photodynamic therapy for the treatment of persistent human papilloma virus infections and cervical intraepithelial neoplasia.
abstract: BACKGROUND
  Current treatments for high-grade cervical intraepithelial neoplasia (CIN2/3) are mainly excisional procedures, which are associated with significant side effects and pose risks for future pregnancies. An effective and safe therapy is needed to reduce the requirement for surgical interventions in women of reproductive age.
  
  
  METHODS
  This review looks at the pharmacokinetic and clinical data for topical hexaminolevulinate (HAL) photodynamic therapy (PDT), which is currently entering late phase clinical trials for high-grade CIN. The authors include published studies in patients and volunteers but laboratory and animal studies have been excluded as have studies on other porphyrins such as Photofrin, 5-aminolevulinic acid, methyl aminolevulinate and studies reporting other clinical applications for HAL.
  
  
  CONCLUSIONS
  Topical HAL PDT has potential as a non-surgical tissue-preserving treatment for CIN and persistent oncogenic human papilloma virus infections. HAL PDT selectively treats the entire epithelial sheet, without the tissue destruction seen in excisional procedures. The authors believe that this treatment could replace surgery in a large proportion of patients. It would be of particular value to the high percentage of women who are interested in future child-bearing. If the treatment is approved, it is very likely that physicians will want to use this treatment, as many patients will be keen to consider a non-surgical option.
authors.affiliation: Hannover Medical School, Department of Obstetrics and Gynaecology , Hannover , Germany +49 511 532 6144 ; +49 511 532 6145 ; Hillemanns.peter@MH-Hannover.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Hillemanns
authors.forename: Mark H
authors.initials: MH
authors.lastname: Einstein
authors.forename: Ole Erik
authors.initials: OE
authors.lastname: Iversen
mesh_terms: D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000150:complications / Q000188:drug therapy; D010778:Photochemotherapy / Q000009:adverse effects / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000493:pharmacokinetics; D002578:Uterine Cervical Dysplasia / Q000188:drug therapy*
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid; C419924:5-aminolevulinic acid hexyl ester
keywords: cervical cancer; cervical intraepithelial neoplasia; hexaminolevulinate; human papilloma virus; photodynamic therapy