Clinical treatment of intra-epithelia cervical neoplasia with photodynamic therapy

医学 宫颈上皮内瘤变 光动力疗法 子宫颈 组织病理学 临床试验 细胞学 阴道镜检查 不利影响 宫颈癌 外科 内科学 病理 癌症 有机化学 化学
作者
Antonio Carlos Figueiredo Vendette,Henrique Luís Piva,Luís Alexandre Muehlmann,Delfrank Ananias de Souza,Antônio Cláudio Tedesco,Ricardo Bentes Azevedo
出处
期刊:International Journal of Hyperthermia [Taylor & Francis]
卷期号:37 (3): 50-58 被引量:17
标识
DOI:10.1080/02656736.2020.1804077
摘要

This clinical study was developed to primarily evaluate the Complete Cytopathological Response Rate of Cervical Intraepithelial Neoplasms to PDT using chitosan nanocapsules containing Chlorocyan-aluminum phthalocyanine as a photoactive agent. Analyses of the Free Recurrence Interval, toxicity profile (immediate and late), and complications (immediate and late), were secondarily analyzed.This study was previously approved by the National Council of Ethics in Research of Brazil (CONEP), on May 28, 2014, under case number 19182113.4.0000.5009. On the surface of the cervix of each selected patient was applied one mL of the formulated gel, and after 30 min, the light was applied. Reports or the identification of adverse effects and/or complications were observed in follow-up visits, in addition to the collection of cervical oncotic cytology.Out of the total group, 11 (91.7%) primarily treated patients evolved with negative cervical oncotic cytology as soon as in the first evaluation following treatment, and one did not achieve any therapeutic benefit, even after reapplication. Two patients with initially positive response presented cytological recurrence determined by histopathology. A new round of PDT was developed, and both evolved with cytological remission three weeks later, remaining negative until the last follow-up. No important side effects were observed in all the patients.Our trial demonstrates that treatment of CIN 1 and 2 lesions using our PDT formulation is feasible and safe. Large randomized clinical trials are required to establish efficacy.
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