The efficacy of laser ablation combined with photodynamic therapy vs PDT for CIN2/3 in reproductive women: a prospective case-control study.

OBJECTIVE

To compare the efficacy of laser ablation combined with photodynamic therapy (LA-PDT) versus PDT alone in the treatment of cervical intraepithelial neoplasia grade 2/3 (CIN2/3).

METHODS

Patients diagnosed with CIN2/3 were enrolled and allocated to either the LA-PDT or the PDT group based on patients' choice. Pathological regression and human papillomavirus (HPV) clearance were compared at 12-month follow-up between the two groups.

RESULTS

A total of 77 patients in the LA-PDT group and 68 patients in the PDT group completed follow-up. Baseline characteristics showed no significant differences between the two groups. At the 12-month follow-up, both the pathological complete remission rate and HPV clearance rate were significantly higher in the LA-PDT group compared to the PDT group (98.7%vs. 86.4%, P < 0.05; 92.3% vs. 86.4%, P < 0.05). Univariate and multivariate analyses indicated that the pre-treatment pathology of CIN3 was an independent risk factor for both lesion persistence and HPV persistence. Among the 111 patients with CIN2, the pathological complete remission rate was 98.2% and the HPV clearance rate was 95.5%. Among the 33 patients with CIN3, both the pathological complete remission rate and HPV clearance rate were significantly higher in the LA-PDT group than in the PDT group (94.1%vs. 56.3%, P < 0.05; 76.5% vs. 37.5%, P < 0.05).

CONCLUSION

LA-PDT for CIN2/3 demonstrates high efficacy and potentially saves time and economic costs. The combined therapy shows significant advantages over PDT alone, particularly for patients with CIN3.