Photodynamic therapy for cervical intraepithelial neoplasia.

Abstract

OBJECTIVES:

Photodynamic therapy (PDT) is a minimally invasive treatment for cervical intraepithelial neoplasia (CIN). We report the effectiveness of PDT in 105 cases of CIN.

METHODS:

All patients received photofrin (PHE) 2 mg/kg intravenously and, 48-60 h later, phototherapy was performed using the Excimer dye laser or a YAG-OPO laser with an irradiation dose of 100 J/cm(2) using 630 nm wavelength.

RESULTS:

Mild photosensitivity occurred in 48% (50/105) of patients. The complete response (CR) rate was 90% (94/105) at 3 months following treatment. In the remaining 11 patients, 5 patients had CIN1, 2 patients had CIN2, and 4 patients had mild cytologic findings. However, in 9 of these 11 patients, CR was achieved 6 months after PDT. In 69 patients, human papilloma virus (HPV) typing was performed before and after PDT therapy. Pre-treatment, 64 of 69 patients (93%), were HPV-positive including 30 cases of high-risk HPV (43%). Testing performed 3, 6 and 12 months following PDT revealed no HPV-DNA in 75% (52/69), 74% (48/65) and 72% (41/57) of patients. At present, the median follow-up period is 636 days (90-2,232 days). In 3 patients, recurrence requiring surgical treatment was identified at 646, 717 and 895 days after PDT.

CONCLUSIONS:

PDT is an effective and minimally invasive treatment for CIN, which also appears to eradicate HPV infection.

• Authors: Satoshi Yamaguchi, Hiroshi Tsuda, Masayuki Takemori, Shinich Nakata, Sadako Nishimura, Naoki Kawamura, Keisuke Hanioka, Takeshi Inoue, Ryuichiro Nishimura
• Journal: Oncology (Oncology) Vol. 69 Issue 2 Pg. 110-6 ( 2005) ISSN: 0030-2414 [Print] Switzerland
• PMID: 16118506 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Dihematoporphyrin Ether

Topics

• Adult
• Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
• Dihematoporphyrin Ether (administration & dosage, adverse effects, therapeutic use)
• Female
• Humans
• Middle Aged
• Neoplasm Recurrence, Local
• Papillomavirus Infections (complications)
• Photochemotherapy (adverse effects, methods)
• Treatment Outcome
• Uterine Cervical Neoplasms (drug therapy, pathology, virology)
• Uterine Cervical Dysplasia (drug therapy, pathology, virology)