Effect of photodynamic therapy on vaginal intraepithelial neoplasia grade one: A retrospective cohort study.

OBJECTIVE

To evaluate the efficacy of photodynamic therapy (PDT) for vaginal intraepithelial neoplasia grade 1 (VaIN1) related to high-risk (Hr)-human papillomavirus (HPV).

METHODS

Participants aged 25-65 years treated for VaIN1 between March 2022 and September 2022 were retrospectively analyzed into three groups. The PDT and follow-up groups were matched 1:1 for gravidity, HPV type, and quadrants involved. The PDT and CO2 laser groups were compared without matching. Patients were followed up at 6, 12, and 24 months.

RESULTS

After matched, the lesion and Hr-HPV clearance rates of the PDT group (89.5%, 89.5%, 92.1%, and 81.6%, 84.2%, 89.5%) were significantly higher than those of the follow-up group (31.6%, 50.0%, 63.2%, and 21.1%, 26.3%, 31.6%, P < 0.05) at 6, 12, and 24 months. But the lesion clearance rates did not differ significantly between the PDT (68.9%, 82.2%, and 91.1%) and CO2 laser groups (68.7%, 78.3%, and 85.5%, P > 0.05) at 6, 12, and 24 months, and so did Hr-HPV clearance rates (PDT as 62.2% and 77.8%, and CO2 laser 54.2% and 61.4%, respectively, P > 0.05) at 6 and 12 months. However, at 24 months, the Hr-HPV clearance rate was higher in the PDT group than in the CO2 laser group (86.7% vs 71.1%, P = 0.047). In the PDT group, none of the lesions progressed.

CONCLUSIONS

Compared with CO2 laser, PDT resulted in a higher Hr-HPV clearance, as well as a low risk of complications and disease progression. PDT is an effective and noninvasive treatment for VaIN1.