PHOTODYNAMIC THERAPY IN TREATMENT OF PATIENTS WITH PREMALIGNANT VULVAR DISEASES. FIRST EXPERIENCE OF THE METHOD...

The aim of the study is to evaluate the tolerability and effectiveness of photodynamic therapy (PDT) of patients with premalignant diseases of the vulva. The study was performed on 10 patients on the basis of the National Cancer Institute of Ukraine (Kyiv). The age of patients ranged from 31 to 67 years old (mean age: 53.3±3.6 years old). The diagnosis was made on the basis of medical history, complaints and clinical examination of patients, vulvoscopy and the results of morphological examination of pathologically altered vulvar tissues. A drug of the chlorine series "Photolon" (RUE "Belmedpreparaty", Republic of Belarus) in doses from 1 to 2.5 mg/kg was used as a photosensitizer (FS). Photoirradiation of pathologically altered foci was performed 3-4 hours after the end of the infusion of FS using a laser coagulator universal "Lika-surgeon" ("Photonics Plus", Ukraine, λ = 660 nm) with a radiation power of 0.4 W in exposure doses of 100 up to 150 J/cm2. PDT tolerability was assessed basing on the frequency and severity of adverse reactions (CTCAE, version 3.0). The effectiveness of PDT was assessed basing on the presence / absence of complaints, data from visual observation of changes in the area of treated lesions and morphological examination data at 3 and 6 months after treatment (WHO criteria). No serious adverse reactions associated with the introduction of FS and PDT session were observed: no allergic reactions (Quincke's edema, urticaria, drop in blood pressure, bronchospasm), no symptoms of skin phototoxicity. In the specified control patients' observation terms, the remission of disease clinical symptoms (an itch in the area of vulva) in the treated pathological centers as well as high frequency of clinical and morphological regressions were noted. The obtained results indicate the relevance and prospects of further research in the field of laser technology and PDT as options for organ-preserving treatment of premalignant diseases of vulva.