The efficacy comparison of laser ablation combined with photodynamic therapy versus LEEP for women with CIN2/3 of childbearing age: a non-randomized case-control study.

OBJECTIVE

To compare the efficacy of laser ablation combined with photodynamic therapy (LA-PDT) versus loop electrosurgical excision procedure (LEEP) in the treatment of cervical intraepithelial neoplasia grade 2/3 (CIN 2/3), and discuss the clinical indications for LA-PDT.

METHODS

180 patients (aged 23-39 years) diagnosed with CIN 2/3 were enrolled in the study. According to patients' personal choice, they were divided into either LA-PDT group or LEEP group. Follow-up was conducted in 12 months to compare the pathological complete remission (CR) and human papillomavirus (HPV) clearance between the two groups.

RESULTS

There were 85 patients in LA-PDT group and 82 patients in LEEP group. Comparison of baseline data between the two groups showed statistical differences in parity (41.2% vs. 58.5%, P=0.025), cytology (12.9% vs. 3.7%, P=0.001) and transformation zone (40.0% vs. 84.1%, P<0.001). After 12 months, pathological CR rate was 96.5% and the HPV clearance rate was 89.4% in the LA-PDT group. In the LEEP group, pathological CR rate was 98.8% and the HPV clearance rate was 84.1%. Pathological CR rates were comparable in the two groups (96.5% vs. 98.8%, P = 0.638). The HPV clearance rate in the LA-PDT group was slightly higher than that in the LEEP group, with no statistical difference (89.4% vs. 84.1%, P = 0.315).

CONCLUSION

The efficacy of LA-PDT appears comparable to that of LEEP for patients with CIN2/3 of childbearing age. LA-PDT is particularly suitable for the patients with fertility desire and whose cervical transformation zone is completely visible.