Background: The current treatment of cervical intraepithelial neoplasia (CIN) is primarily based on surgical excision using laser, a loop electrosurgical procedure, or a cold knife technique. Unfortunately, these treatments often lead to obstetrical problems during the subsequent pregnancy, particularly in young women. Photodynamic therapy (PDT), which uses a topical or intravenous photosensitizer (PS) activated by a light source to ablate abnormal tissue, offers a minimally invasive alternative. The purpose of this study was to comprehensively assess the effectiveness and safety of PDT in the treatment of CIN.
Methods: Following Cochrane guidelines, a comprehensive systematic review of all clinical studies and reports examining the use of PDT for CIN was conducted. Study quality was assessed using the Oxford Levels of Evidence Scale.
Results: The 14 studies included two randomized control trials (RCTs), one case-control study, and 11 case series. Among the 506 patients studied, 472 were included to study the effectiveness of PDT on CIN and 10 were lost to follow-up. An assessment of clinical effectiveness included the response of the lesion to treatment (may include lesion recurrence) reported by all 14 studies. The complete response rate (CRR) of PDT on CIN ranged from 0% to 100%. HPV eradication rate (HER) was reported in seven studies, with rates ranging from 53.4% to 80.0%.
Conclusions: PDT is a safe and tolerable treatment for CIN. Evidence regarding the efficacy of PDT for CIN is conflicting, which may, in part, be explained by the limited number of controlled comparative clinical trials.
Keywords: Cervical intraepithelial neoplasia; Photodynamic therapy; Review.
Copyright © 2014. Published by Elsevier B.V.