Efficacy and safety of topical photodynamic therapy for genital warts: experience review in China

Abstract

SignificanceHigh recurrence rate and adverse effects were common shortcomings in treatments for genital warts, and the inaccessibility of some deep meatal lesions remains an intractable problem. This study aims to evaluate the treatment of PDT for genital warts in comparison to alternative treatments. ApproachSeven databases and ClinicalTrials. gov were searched and seven randomized controlled trials were finally included. ResultsThere was no significant difference in clearance rate of urethral lesions between the PDT group and the CO2 laser therapy (CO2-LT group) (Odds ratio [OR] 0.676, 95% confidence interval [CI] 0.071–6.426, P = 0.734), but the overall clearance rate of all genital warts was slightly lower for PDT (OR 0.574, CI 0.335–0.985, P = 0.044). The recurrence rate after PDT was significantly lower than after CO2-LT (OR 0.318, CI 0.220–0.460, P < 0.001), and adverse effects were also slighter after PDT (OR 0.015, CI 0.003–0.074, P < 0.001). In addition, a modification of parameters of light irradiation provides the potential to alleviate pain. This study shows that PDT is an effective treatment for genital warts with good tolerability and safety, especially for cavitary lesions. Some modified protocols probably have the potential to reduce adverse effects. ConclusionsIn all, this study demonstrates that PDT is a favorable treatment for genital warts with high efficacy, low recurrence rate and mild adverse effect, especially for urethral and other cavitary lesions. Besides, some modified protocols probably had the potential to reduce adverse effects, but still needed further investigation.