Photodynamic Therapy in the Management of Cervical Intraepithelial Neoplasia

Abstract

Objective : The purposes of this study are to determine the effectiveness of photodynamic therapy(PDT) and to compare the effectiveness between PDT and LEEP in the management of cervical intraepithelial neoplasia. Materials and Methods : A comparative study of 52 young women with cervical intraepithelial neoplasia at Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Pochon CHA University Medical College from May 2002 to August 2003,was followed up more than 6 months. All of 52 cases had Pap smear, punch biopsy, cervicogram, HPV test before and after management. 26 cases were treated with PDT. 26 cases were treated with LEEP, All PDT-treated cases received (2mg/kg) I.V. and a diode laser(Ceralas PDT, ceramoptec GmbH, Bonn Germany) providing light at 635 nm with total light dose of 150 J/cm2 at 48 hours. Clinical characteristics between two group had statistically no difference. Student T-test and -test were used to compare the effectiveness between PDT and LEEP. Results : Cure rate of cervical intraepithelial neoplasias was 92.3% in photodynamic therapy group, and 96.0% in the LEEP group. Eradication of HPV infection was 83.3% in photodynamic therapy group and 81% in the LEEP group. Postoperative complications were tolerable in photodynamic therapy group. Conclusions : The cure rates and eradication of HPV infection of photodynamic therapy were comparable with LEEP in the management of cervical intraepithelial neoplasias. The photodynamic therapy may be an alternative method for selective tissue destruction to preserve fertility in the management of cervical intraepithelial neoplasia.