HiPorfin photodynamic therapy for vaginal high-grade squamous intraepithelial lesion

医学 光动力疗法 病变 Ascus(苔藓虫) 鳞状上皮内病变 细胞学 泌尿科 内科学 胃肠病学 妇科 病理 宫颈癌 癌症 宫颈上皮内瘤变 化学 有机化学 植物 子囊孢子 孢子 生物
作者
Yu Liu,Ruifang Wu,Changzhong Li,Lvfang Duan,Lihui Wei,Ruizhen Li
出处
期刊:Archives of Gynecology and Obstetrics [Springer Nature]
标识
DOI:10.1007/s00404-024-07600-4
摘要

Abstract Purpose We aimed to evaluate the efficacy and safety of HiPorfin-photodynamic therapy (PDT) in women with vaginal high-grade squamous intraepithelial Lesion (HSIL). Methods Retrospective analysis of eighteen patients with vaginal HSIL received HiPorfin-PDT between June 2019 and May 2023. Illumination with a 630-nm laser light was applied to the lesions 48–72 h after intravenous injection of 2 mg/kg HiPorfin ® . The light dose to the lesions was 150 J/cm 2 . Results The mean age of the 18 patients was 45.8 years (range, 24 to 63). The complete response (CR) rate was 66.7% (12/18), 83.3% (15/18) and 83.3% (15/18) at 3, 6 and 12 months after PDT, respectively. Patients who achieved CR showed no signs of recurrence during long-term follow-up. There were three cases of persistent disease showing partial response (PR) and the lesion area was significantly reduced more than 50%. One patient with persistent disease then underwent thermocoagulation one time and subsequently showed no evidence of HSIL. Pre-treatment, 100% (18/18) patients were high-risk human papilloma virus (HR-HPV)-positive. HPV eradication rate was 16.7% (3/18), 22.2% (4/18) and 44.4% (8/18) after PDT at 3, 6 and 12 months, respectively. Before treatment, liquid-based cytology test ≥ atypical squamous cells of undetermined significance (ASCUS) was 94.4% (17/18). Negative conversion ratio of cytology was 47.1% (8/17), 52.9% (9/17) and 76.5% (13/17) at 3, 6 and 12 months, respectively. There were no serious adverse effects during and after PDT. Conclusions HiPorfin-PDT may be an effective alternative treatment for vaginal HSIL for organ-saving and sexual function protection.

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