Yao Hongxia, Zhang Haiyan, Pu Xiaowen, Shi Lei, Zhang Yunfeng, Wang Peiru, Zhang Guolong, Zhou Zhongxia, Zhou Weiqiang, Wang Xiuli
Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China.
Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China.
Photodiagnosis Photodyn Ther. 2020 Jun;30:101731. doi: 10.1016/j.pdpdt.2020.101731. Epub 2020 May 11.
To evaluate the clinical efficacy and safety of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) combined with a carbon dioxide laser (CO laser + PDT) versus CO laser for the treatment of low-grade vaginal intraepithelial neoplasms (vaginal LSIL).
We recruited 40 patients with vaginal LSIL and persistent HR-HPV infection and divided these individuals into two groups. The CO laser + PDT group (20 patients) received one CO laser treatment and three treatments of ALA-PDT over a one-week interval. The CO laser group (20 patients) received up to three CO laser treatments. All patients were followed up at 1 month, 3 month, 6 month and 1 year. Hybrid capture HPV DNA assay and colposcopic biopsy were performed for both groups before treatment and during each of the follow-ups. Adverse effects were also assessed.
The complete remission (CR) rates were 65 % (13/20) in the CO laser group and 85 % (17/20) in the CO laser + PDT group (p > 0.05). HR-HPV remission rates were 25 % (5/20) in the CO laser group and 95 % (19/20) in the CO laser + PDT group (p < 0.05) at one year after treatment. In the CO laser group, one patient experienced severe bleeding during treatment. Twelve patients had varying degrees of adhesions and vaginal scar stenosis. One patient underwent vaginal "dead angle" after repeated CO laser treatment. No severe adverse events or systemic side effects were observed in the CO + PDT group.
Topical ALA-PDT combined with CO laser is an effective, safe, and well-tolerated treatment for vaginal LSIL and HR-HPV infections.
评估5-氨基酮戊酸光动力疗法（ALA-PDT）联合二氧化碳激光（CO激光+PDT）与单纯CO激光治疗低度阴道上皮内瘤变（阴道LSIL）的临床疗效和安全性。
招募40例阴道LSIL且持续性高危型人乳头瘤病毒（HR-HPV）感染患者，将其分为两组。CO激光+PDT组（20例患者）接受1次CO激光治疗及每隔1周进行3次ALA-PDT治疗。CO激光组（20例患者）接受最多3次CO激光治疗。所有患者在1个月、3个月、6个月和1年时进行随访。两组在治疗前及每次随访时均进行杂交捕获HPV DNA检测和阴道镜活检，并评估不良反应。
CO激光组的完全缓解（CR）率为65%（13/20），CO激光+PDT组为85%（17/20）（p>0.05）。治疗1年后，CO激光组的HR-HPV缓解率为25%（5/20），CO激光+PDT组为95%（19/20）（p<0.05）。CO激光组有1例患者在治疗期间发生严重出血。12例患者出现不同程度的粘连和阴道瘢痕狭窄。1例患者在重复CO激光治疗后出现阴道“死角”。CO+PDT组未观察到严重不良事件或全身副作用。
局部ALA-PDT联合CO激光是治疗阴道LSIL和HR-HPV感染的一种有效、安全且耐受性良好的治疗方法。
