Evaluating photodynamic therapy protocols for high-grade cervical neoplasia: A comparative study

Area of Science:

• Gynecology
• Oncology
• Photomedicine

Background:

• Human Papillomavirus (HPV) infection is a primary cause of cervical cancer.
• Cervical Intraepithelial Lesions (CIN) are precancerous changes requiring effective treatment.
• Photodynamic Therapy (PDT) offers a non-invasive approach for HPV-infected cells.

Purpose of the Study:

• To compare three Photodynamic Therapy (PDT) protocols for treating high-grade Cervical Intraepithelial Lesions (CIN) in HPV-positive patients.
• To evaluate the efficacy of different PDT session numbers and intervals.
• To assess lesion regression, cure rates, and HPV viral load clearance.

Main Methods:

• Prospective, randomized study involving 31 patients with high-grade CIN and HPV infection.
• Standardized PDT protocol using 630 nm LEDs and 150 J/cm² fluence.
• Comparison of three groups with varying numbers of sessions and intervals between treatments.

Main Results:

• No statistical difference between protocols, but a clinical trend favored two PDT sessions with a 21-day interval.
• After 120 days, 50% of patients showed lesion regression (CIN I or chronic cervicitis).
• An 80% cure rate was observed after 6 months, with 50% of high-risk HPV carriers clearing the viral load.

Conclusions:

• Optimizing PDT protocols, specifically increasing sessions and intervals, enhances treatment outcomes.
• PDT with a 21-day interval promotes tissue regeneration and viral clearance for CIN.
• This approach presents an effective alternative for managing HPV-related cervical lesions.