Photodynamic therapy in the treatment of patients with vulvar premalignant diseases. First experience of its use in Ukraine

Abstract

Objective of the study was to evaluate the tolerability and effectiveness of photodynamic therapy (PDT) in patients with vulvar premalignant diseases.Materials and methods. Study was performed in 10 patients on the basis of the National Cancer Institute of Ukraine (Kyiv). Age of patients ranged from 31 to 67 years old (mean age 53.3 ± 3.6 years old). Diagnosis was made on the basis of medical history, complaints and clinical examination of patients, vulvoscopy and results of morphological examination of pathologically altered vulvar tissues. A drug of the chlorine series “Photolon” (RUE “Belmedpreparaty”, Republic of Belarus) in doses from 1 to 2.5 mg/kg was used as a photosensitizer (FS). Photoirradiation of pathologically altered foci was performed 3–4 hours after the end of the FS infusion using a laser coagulator universal “Lika-surgeon” (“Photonics Plus”, Ukraine, λ = 660 nm) with a radiation power of 0.4 W in exposure doses of 100 up to 150 J/cm2. PDT tolerability was assessed basing on the frequency and severity of adverse reactions (CTCAE, version 3.0). PDT effectiveness was assessed basing on the presence/absence of complaints, data from visual observation of changes in the area of treated lesions and morphological examination data at 3 and 6 months after treatment (WHO criteria).Results. No serious adverse reactions associated with FS infusion and PDT session were observed: no allergic reactions (Quincke’s edema, urticaria, drop in blood pressure, bronchospasm), no symptoms of skin phototoxicity. There was remission of clinical symptoms (itch in the area of vulva) in the treated pathological centers and high frequency of clinical and morphological regressions in the control observation terms of patients.Conclusion. Obtained results indicate the relevance and prospects of further researches in the field of laser technology and PDT as options for organ-preserving treatment of vulvar premalignant diseases