Abstract | OBJECTIVE: METHODS: We reviewed the medical records of patients with CIN who had been treated by PDT. Among a total of 73 patients who received PDT for CIN II/III between September 2000 and August 2011, 59 patients aged 40 or younger and who wished to preserve fertility were included. Patients were divided into four groups: group (I) only PDT without LEEP (n = 13), group (II) PDT combined with LEEP/Cone (n = 15), group (III) PDT due to positive LEEP/Cone margin (n = 25), group (IV) PDT for recurrent CIN after LEEP/Cone (n = 6). Surface photoillumination with red laser light at a wavelength of 630 nm was applied to the uterine cervix and endocervical canal of patients 48 hours after an intravenous injection of 2 mg/kg of photosensitizer. RESULTS: The median age of the 59 patients (CIN 2: 4, CIN 3: 22, carcinoma in situ: 31, adenocarcinoma in situ: 2) was 30.4 years. Twenty-two patients were unmarried and 38 were nulliparous. The complete remission (CR) rate was 98.1% (52/53) at 1 year follow-up except six patients followed up loss. The remaining one had recurred at 1 year after PDT, and one residual case at 3 months follow-up was regarded as CR showing NED after secondary PDT. Human papilloma virus (HPV) typing was performed. Before treatment HPV infection rate was 96.3% (52/54). HPV DNA could be no longer detected in 89.8% (44/49) and 87.0% (40/46) at 3 and 12 months after PDT. Among 29 patients who tried to be pregnant, 18 patients achieved 25 pregnancies (6 abortions, 1 ectopic, 1 preterm, 15 term, and 2 ongoing pregnancies.) There has been no fetal loss due to incompetent internal os of cervix. For adverse events, photosensitivity occurred in 13.6% (8/59) and cervical stenosis occurred in one patient. CONCLUSIONS:
PDT combined with or without LEEP/Cone may be a potential alternative for effective conservative treatment of CIN in young patients who wish to preserve fertility.
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Authors | Min Chul Choi, Sang Geun Jung, Hyun Park, Sun Young Lee, Chan Lee, Yeun Young Hwang, Seung Jo Kim |
Journal | Lasers in surgery and medicine
(Lasers Surg Med)
Vol. 45
Issue 9
Pg. 564-72
(Nov 2013)
ISSN: 1096-9101 [Electronic] United States |
PMID | 24136239
(Publication Type: Comparative Study, Evaluation Study, Journal Article)
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Copyright | © 2013 Wiley Periodicals, Inc. |
Chemical References |
- Hematoporphyrins
- Photosensitizing Agents
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Topics |
- Adult
- Combined Modality Therapy
- Conization
(methods)
- Female
- Fertility Preservation
(methods)
- Follow-Up Studies
- Hematoporphyrins
(therapeutic use)
- Humans
- Injections, Intravenous
- Neoplasm Recurrence, Local
(drug therapy)
- Photochemotherapy
(methods)
- Photosensitizing Agents
(therapeutic use)
- Pregnancy
- Pregnancy Rate
- Retrospective Studies
- Treatment Outcome
- Uterine Cervical Neoplasms
(drug therapy, pathology, surgery)
- Uterine Cervical Dysplasia
(drug therapy, pathology, surgery)
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