Photodiagnosis and photodynamic therapy · 2026
Efficacy and safety of 5-ALA-PDT in patients with persistent HR-HPV infection and lower genital tract low-grade intraepithelial lesions after cervical conization.
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Liu Xiaoli, Zhang Ting, Zou Deyuan, Zhang Junhua, Xu Ying, Liu Hongli, Meng Lihua, Zhang Youzhong, Li Huamin, Chen Yikai, Wang Lili, Jia Lin
Аннотация
OBJECTIVE: This study aimed to evaluate the efficacy and safety of 5-aminolevulinic acid-mediated photodynamic therapy (5-ALA-PDT) in patients with persistent high-risk human papillomavirus (HR-HPV) infection and low-grade squamous intraepithelial lesions (LSIL) after cervical conization.
METHODS: A total of 83 patients with HR-HPV infection and LSIL who underwent cervical conization (with negative margins) for high-grade squamous intraepithelial lesions (HSIL) were enrolled in this study. All patients received 5-ALA-PDT at intervals of 7-14 days, for a total of 6 sessions. At 6 months after treatment, evaluations were performed using HPV testing, ThinPrep Cytologic Test (TCT), and colposcopy. The primary outcome measures were the HR-HPV clearance rate and lesion regression rate.
RESULTS: At 6 months after 5-ALA-PDT, the HR-HPV clearance rate was 74.70% (62/83), the lesion regression rate was 93.98% (78/83), and the simultaneous clearance rate of HR-HPV and lesions was 74.70% (62/83). Further analysis of the effects of age and HPV type on 5-ALA-PDT efficacy showed that the HR-HPV clearance rates at 6 months of follow-up, in descending order, were as follows: the ≤50 years old group with other HR-HPV genotypes (81.81%), the ≤50 years old group with HPV 16/18 infection (75.86%), the >50 years old group with other HR-HPV genotypes (64.29%), and the >50 years old group with HPV 16/18 infection (57.14%); however, these differences were not statistically significant. During the treatment period, no disease progression was observed in any patient, and no severe adverse events were reported.
CONCLUSION: 5-ALA-PDT is a safe and noninvasive treatment that can effectively clear HR-HPV infection and promote the regression of LSIL. It provides a viable alternative treatment option for patients who desire active treatment but are either unsuitable for or unwilling to undergo repeat surgery.
METHODS: A total of 83 patients with HR-HPV infection and LSIL who underwent cervical conization (with negative margins) for high-grade squamous intraepithelial lesions (HSIL) were enrolled in this study. All patients received 5-ALA-PDT at intervals of 7-14 days, for a total of 6 sessions. At 6 months after treatment, evaluations were performed using HPV testing, ThinPrep Cytologic Test (TCT), and colposcopy. The primary outcome measures were the HR-HPV clearance rate and lesion regression rate.
RESULTS: At 6 months after 5-ALA-PDT, the HR-HPV clearance rate was 74.70% (62/83), the lesion regression rate was 93.98% (78/83), and the simultaneous clearance rate of HR-HPV and lesions was 74.70% (62/83). Further analysis of the effects of age and HPV type on 5-ALA-PDT efficacy showed that the HR-HPV clearance rates at 6 months of follow-up, in descending order, were as follows: the ≤50 years old group with other HR-HPV genotypes (81.81%), the ≤50 years old group with HPV 16/18 infection (75.86%), the >50 years old group with other HR-HPV genotypes (64.29%), and the >50 years old group with HPV 16/18 infection (57.14%); however, these differences were not statistically significant. During the treatment period, no disease progression was observed in any patient, and no severe adverse events were reported.
CONCLUSION: 5-ALA-PDT is a safe and noninvasive treatment that can effectively clear HR-HPV infection and promote the regression of LSIL. It provides a viable alternative treatment option for patients who desire active treatment but are either unsuitable for or unwilling to undergo repeat surgery.