Mohamed Shaie Kowthar, Abdulkadir Ali Mohamed, Andrea Mlambo, Yan Hu
First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Lasers Med Sci. 2025 May 22;40(1):237. doi: 10.1007/s10103-025-04480-1.
Photodynamic therapy has become a promising non-invasive method for the treatment of LSIL associated with HR-HPV infections. This literature review assesses the efficacy, safety, and clinical relevance of PDT for managing HPV-related cervical lesions. PDT employs photosensitizers, such as 5-aminolevulinic acid, which selectively accumulate in abnormal cervical tissues. When subjected to particular wavelengths of light, these agents become activated and produce reactive oxygen species, leading to the target elimination of particular cells. Numerous studies have documented the effectiveness of PDT with pathological regression rate improving to 94.79%, and the HR-HPV clearance rate increased to 93.75%. Beyond facilitating lesion regression, PDT also plays a significant role in eliminating persistent HR-HPV infections, which are a crucial element in the advancement of cervical dysplasia. Furthermore, the non-invasive nature of PDT presents a compelling alternative to traditional surgical approaches, which may compromise fertility and cause cervical stenosis. PDT is generally well-tolerated; adverse reactions are typically mild and transient, including symptoms such as abdominal discomfort and increased vaginal discharge. Most notably, the fertility-preserving characteristics of PDT render it an optimal treatment choice, particularly for young women desiring to maintain their reproductive potential. While the existing data is promising, it is essential to conduct additional research to enhance treatment protocols, optimize dosages, and thoroughly assess the long-lasting impact of photodynamic therapy in the field of gynecology. By synthesizing existing evidence, this review supports the enhanced incorporation of PDT into clinical decision-making frameworks for the management of HPV-related LSIL.
光动力疗法已成为治疗与高危型人乳头瘤病毒(HR-HPV)感染相关的低度鳞状上皮内病变(LSIL)的一种有前景的非侵入性方法。这篇文献综述评估了光动力疗法治疗HPV相关宫颈病变的疗效、安全性和临床相关性。光动力疗法使用光敏剂,如5-氨基酮戊酸,其可选择性地在异常宫颈组织中积聚。当受到特定波长的光照射时,这些药物被激活并产生活性氧,从而导致特定细胞的靶向清除。大量研究记录了光动力疗法的有效性,病理消退率提高到94.79%,高危型人乳头瘤病毒清除率提高到93.75%。除了促进病变消退外,光动力疗法在消除持续性高危型人乳头瘤病毒感染方面也发挥着重要作用,而持续性感染是宫颈发育异常进展的关键因素。此外,光动力疗法的非侵入性为传统手术方法提供了一个有吸引力的替代方案,传统手术方法可能会损害生育能力并导致宫颈狭窄。光动力疗法一般耐受性良好;不良反应通常轻微且短暂,包括腹部不适和阴道分泌物增多等症状。最值得注意的是,光动力疗法的保留生育能力的特性使其成为最佳治疗选择,特别是对于希望保留生殖潜力的年轻女性。虽然现有数据很有前景,但有必要进行更多研究以改进治疗方案、优化剂量,并全面评估光动力疗法在妇科领域的长期影响。通过综合现有证据,本综述支持将光动力疗法更多地纳入HPV相关低度鳞状上皮内病变管理的临床决策框架。