Course Of Photodynamic Therapy Research Articles

Three-year outcome of photodynamic therapy combined with VEGF inhibitor for pachychoroid neovasculopathy.

Long-term results of photodynamic therapy (PDT) combined with vascular endothelial growth factor (VEGF) inhibitors for pachychoroid neovasculopathy (PNV) are not yet clear. This study is a retrospective, observational case series. We retrospectively examined untreated PNV cases (22 cases, 22 eyes, mean age of 71.0years) who underwent PDT therapy in combination with VEGF inhibitors followed by additional treatments with pro re nata protocol. Visual acuity, number of treatments, and time to recurrence were examined. In addition, foveal choroidal thickness and choroidal vascularity index (CVI) were evaluated in 13 of 22 patients who were followed up with SpectralisOCTR from baseline. Fifteen (68%) cases had polyps at baseline. LogMAR visual acuity averaged 0.24 ± 0.20 (range, - 0.079 to 0.82) at baseline and significantly improved after 1, 2, and 3years (p = 0. 004, 0.0003, 0.002, respectively). Fourteen patients (64%) recurred, with an average time to recurrence of 1.8 ± 0.9years. Foveal choroidal thickness decreased significantly after 1year (average from 326μm to 263μm) and remained unchanged up to 3years (255μm). CVI also decreased after 1year (average from 0.62 to 0.61) and remained unchanged until 3years later (0.60). We examined the 3-year course of PDT in combination with the VEGF inhibitor for untreated PNV. Visual acuity was improved, foveal choroidal thickness and CVI were decreased after 3years.

Photodynamic therapy for a patient with basal cell skin cancer of the lower eyelid (clinical case)

The article provides an example of successful treatment of a patient with basal cell skin cancer of the lower eyelid of the right eye, stage IB cT2aN0M0, with the presence of concomitant pathology – a decrease in the activity of plasma factor XII of blood coagulation (Hageman disease). The patient’s medical history is associated with long-term ineffective treatment of the tumor with Curaderm ointment. After diagnosis and further examination at the Moscow Research Institute named after. P.A. Herzen, at the Center for Laser and Photodynamic Diagnostics and Therapy of Tumors, the patient underwent organ-preserving treatment using photodynamic therapy. 1 course of photodynamic therapy with the photosensitizer chlorin e6 was carried out. Complete tumor regression was obtained; relapse-free follow-up period was 1 year

The analysis of HPV integration sites based on nanopore sequencing and the profiling changes along the course of photodynamic therapy

ObjectiveTo detect the HPV genotype and integration sites in patients with high-risk HPV infection at different stages of photodynamic therapy using nanopore technology and to evaluate the treatment effect.MethodsFour patients with HPV infection were selected and subjected to photodynamic therapy, and cervical exfoliated cell was sampled at before treatment, after three courses of treatment and six courses of treatment, their viral abundance and insertion sites were analyzed by nanopore technology, and pathological examinations were performed before and after treatment. In this study, we developed a novel assay that combined viral sequence enrichment and Nanopore sequencing for identification of HPV genotype and integration sites at once. The assay has obvious advantages over qPCR or NGS-based methods, as it has better sensitivity after viral sequences enrichment and can generate long-reads (kb to Mb) for better detection rate of structure variations, moreover, fast turn-around time for real-time viral sequencing and analysis.ResultsThe pathological grade was reduced in all four patients after photodynamic therapy. Virus has been cleared in two cases after treatment, the virus amount reduced after treatment but not completely cleared in one case, and two type viruses were cleared and one type virus persisted after treatment in the last patient with multiple infection. Viral abundance and the number of integration sites were positively correlated. Gene enrichment analysis showed complete viral clearance in 1 patient and 3 patients required follow-up.ConclusionNanopore sequencing can effectively monitor the abundance of HPV viruses and integration sites to show the presence status of viruses, and combined with the results of gene enrichment analysis, the treatment effect can be dynamically assessed.

Clinical case of successful application of photodynamic therapy in advanced vulvar cancer

A significant therapeutic effect of photodynamic therapy (PDT) is shown in a patient with extensive vulvar cancer after ineffective surgical and chemoradiotherapy. During the year, three courses of local PDT with a photosensitizer based on chlorin e6 were carried out. The photosensitizer was administered intravenously three hours before irradiation at a dose of 1.2 mg/kg. For laser irradiation (662 nm) of the vulvar tumor, a light guide for external irradiation was used: the power density was 0.2 W/cm2, the light dose was from 100 to 250 J/cm2. As a result of treatment, tumor regression and stable remission are observed. The patient remains under observation.

Photodynamic therapy use for malignant neoplasms of extrahepatic bile ducts and major duodenal papilla in inoperable patients

Introduction. The article presents the results of photodynamic therapy (PDT) of extrahepatic bile ducts (EBD) and large duodenal papilla (LDP) cancer in inoperable patients. The technique of its carrying out and ways of delivery of laser light guides to various parts of biliary tract are described. Efficiency of PDT for cancer of LDP and separately for cancer of EBD was determined. The dependence of patients' life expectancy on the number of PDT sessions during a year was revealed and the comparative analysis of two groups of photosensitizers (PS) efficiency was carried out.Research purpose: to estimate the effectiveness of photodynamic therapy (PDT) in treatment of VUC and IBD cancer; to determine the reasonability of repeated PDT courses and time intervals between them; to compare the effectiveness of photosensitizers Photodetazine and Photosens in treatment of these patients.Materials and Methods. The study was based on a comparative analysis of life expectancy in inoperable groups of patients with VVC and IBD cancer. The main group consisted of 29 patients (including 20 patients with IBD cancer) who were treated by PDT besides biliary operations. Control group consisted of 50 patients (14 of them with BDZ cancer), only biliary drainage interventions were used in their treatment. The number of PDT courses performed was from 1 to 3 during the year. A total of 29 patients underwent 52 courses of PDT. We used two photosensitizers from different groups: Fotoditazin (chlorine derivative E6) – was used in 18 patients and Photosense (phthalocyanine derivative) – was used as PS in 11 patients. Assessment of treatment efficacy was based on determining the median survival according to the Kaplan-Meier method.Results. Median survival time in the main group was 18 months [95% CI: 15.9; 20.1], in the comparison group (without PDT) – 7 months [95% CI: 5.1; 8.9]. In patients with IBD cancer, the median survival for PDT was 18 months [95% CI: 16; 20], and 12 months [95% CI: 9.25; 14.75] in the comparison group. Life expectancy for patients with BDS cancer ranged from 1 to 60 months. Median survival time was 17 months [95% CI: 12; 21] in case of Fotosens – 18 months [95% CI: 16; 19]. In the group of patients who underwent one PDT session during a year, median survival time was 12.5 months [95% CI: 10; 15], in the group of patients who underwent 2 or more sessions, median survival time was 23 months [95% CI: 18; 28].Conclusions. Photodynamic therapy in combination with draining interventions on bile ducts is an effective method of therapy of inoperable forms of IVC and IBD carcinoma in high risk patients. Variants of delivery of laser radiation for PDT are developed. Repeated sessions of PDT at intervals of 4-6 months potentiate the effectiveness of palliative therapy and increase life expectancy of patients. The effectiveness of Fioditazine and Photosense in PDT was found to be similar. Fotoditazine showed a lower number of complications.

Photodynamic therapy in a patient with hpv-associated lsil of the cervice (clinical case)

The article describes a clinical example of timely, safe and effective photodynamic therapy (PDT) in a patient diagnosed with human papillomavirus (HPV) CIN I-associated cervical cancer after ineffective vaccination with 4-valent Gardasil vaccine. Clinical case demonstrates the low effectiveness of HPV vaccination in patients with established HPV infection. In this patient, the lack of adequate treatment for about 1.5 years led to the development of HPV associated CIN I of the cervix. Center for Laser and Photodynamic Diagnostics and Therapy of Tumors and MRI P.A. Herzen, the patient underwent a course of antiviral PDT with the achievement of complete regression of dysplasia and complete eradication of HPV viruses. The patient tolerated the treatment well, without complications. The period of relapse-free follow-up is 19 months.

Photodynamic therapy of a patient with basal cell skin cancer of the ear stage T3N0M0 (clinical case)

The article presents a clinical observation. The patient, 72 years old, applied to the MNII them. P.A. Herzen with complaints about the presence of an ulcerated tumor of the left ear. After further examination, a diagnosis was made - basal cell carcinoma of the ear skin with spread to the skin of the parotid region T3N0M0. On July 9, 2021, the patient underwent a course of photodynamic therapy (PDT) using a photosensitizer based on chlorin e6 and a diode laser with a wavelength of 662 nm. After one course of PDT, complete regression of the tumor was recorded.

Phototheranostics of Cervical Neoplasms with Chlorin e6 Photosensitizer.

Simple SummaryNeoplasms of the cervix are the most common types of oncological pathology. Photodynamic therapy with intravenous administration of the photosensitizer chlorin e6 shows high efficiency in the treatment of precancerous lesions of the cervix with complete eradication of the human papillomavirus. The treatment method can reduce deaths from cervical cancer and preserve fertility in patients. Spectral and video fluorescence diagnostics allows intraoperatively assessing the degree of photosensitizer accumulation and photobleaching and visualizing the boundaries of pathologically altered tissues.(1) Purpose: Improving the treatment effectiveness of intraepithelial neoplasia of the cervix associated with human papillomavirus infection, based on the application of the method of photodynamic therapy with simultaneous laser excitation of fluorescence to clarify the boundaries of cervical neoplasms. (2) Methods: Examination and treatment of 52 patients aged 22 to 53 years with morphologically and cytologically confirmed mild to severe intraepithelial cervix neoplasia, preinvasive, micro-invasive, and squamous cell cervix carcinoma. All patients were carriers of human papillomavirus infection. The patients underwent photodynamic therapy with simultaneous laser excitation of fluorescence. The combined use of video and spectral fluorescence diagnostics for cervical neoplasms made it possible to control the photodynamic therapy process at all stages of the procedure. Evaluation of the photodynamic therapy of intraepithelial cervical neoplasms was carried out with colposcopic examination, cytological conclusion, and morphological verification of the biopsy material after the photodynamic therapy course. The success of human papillomavirus therapy was assessed based on the results of the polymerase chain reaction. (3) Results. The possibility of simultaneous spectral fluorescence diagnostics and photodynamic therapy using a laser source with a wavelength of 660 nm has been established, making it possible to assess the fluorescence index in real-time and control the photobleaching of photosensitizers in the irradiated area. The treatment of all 52 patients was successful after the first photodynamic therapy procedure. According to the PCR test of the discharge from the cervical canal, the previously identified HPV types were not observed in 48 patients. Previously identified HPV types were absent after repeated PDT in four patients (CIN III (n = 2), CIS (n = 2)). In 80.8% of patients, regression of the lesion was noted. (4) Conclusions. The high efficiency of photodynamic therapy with intravenous photosensitizer administration of chlorin e6 has been demonstrated both in relation to eradication therapy of human papillomavirus and in relation to the treatment of intraepithelial lesions of the cervix.

РЕЗУЛЬТАТЫ ЛЕЧЕНИЯ ЛОКАЛЬНОГО РЕЦИДИВА И ПРОДОЛЖЕННОГО РОСТА МЕЛАНОМЫ СОСУДИСТОЙ ОБОЛОЧКИ ГЛАЗА У ПАЦИЕНТОВ С ИСПОЛЬЗОВАНИЕМ ФОТОДИНАМИЧЕСКОЙ ТЕРАПИИ

Background. The proportion of recurrence and continued growth (RC) of choroidal melanoma after organ- preserving treatment is 19%. Purpose. To perform a comparative assessment of the results of treatment of patients with RC of choroidal melanoma using photodynamic therapy (PDT) in comparison with brachytherapy (BT) and enucleation. Material and methods. Data from the Belarusian Cancer Registry of 60 patients with RC melanoma of the choroid for the period from February 2009 to November 2020. The average age is 65.3±13.17 years. For PDT, a photosensitizer "Photolon" was used, with the action of a laser device "UPL-PDT" with a wavelength of 665±5 nm, with a dose to the tumor surface of 100 kJ / cm2. Results. After 1 course of PDT, the tumor resorbed in 5 patients. 15 has stabilization with residual tumor tissue h=1.8±1.4 mm; l=6.05±3.4 mm. Median visual acuity (VA) – 0.1 (IQR 0.05-0.2). After BT, the tumor resorbed in 13 patients. 7 registered stabilization with h=0.15 (IQR 0.05-0.2 mm); l=0 (IQR 0-6.07 mm). The median VA was 0.03 (IQR 0.01-0.09). The overall 5th disease-free survival rate in the three groups was 43.2±6.9%. The overall 5-year survival rate with organ-preserving treatment was 100% in the groups after PDT and BT and 94.7±5.1% after enucleation. Conclusions. PDT allows you to preserve residual vision in patients in comparison with radiation therapy. The results of the analysis of recurrence-free survival in patients with RC of choroidal melanoma make it possible to give preference to organ-preserving methods of treatment.

Experience of using photodynamic therapy for treatment of genitourinary syndrome of menopause

This study reports about efficacy and safety of photodynamic therapy in Genitourinary Syndrome of Menopause (GSM).Material and methods. The study group included 12 patients with a diagnosis of urogenital syndrome of menopause. The trismeglumine salt of chlorin E6 in the form of a 1% gel was used as a photosensitizer. LED phototherapy apparatus Garmonia (photodynamic therapy apparatus (emitter 660 nm) was used as a radiation source. The PDT procedure was performed once every 7 days. The following scales were used to assess the effectiveness: Vaginal Health Index, Visual Analogue Scale, Dermatology Life Quality Index score, and general satisfaction with the course of procedures was also assessed.Results. The patients noted a significant regression of itching, burning, pain and dyspareunia after the course of photodynamic therapy. There was a decrease in dryness, on average, up to 3 points upon completing the course of procedures. Itching completely regressed in 6 out of patients. Dyspareunia significantly decreased in 4 patients and completely disappeared in 2 patients. The greatest effect according to the results of assessing the index of vaginal health was noted in relation to Ph-metry, as well as in relation to elasticity (4.17 points) and moisture (4.33 points). The median satisfaction score with treatment outcomes was 2.7 at last follow-up. There were no serious side effects during the entire period of treatment and after it.Conclusions. The following study reports that the photosensitizer with trismeglumine salt of chlorin E6 and PDT with a wavelength of 660 nm with an exposure for 30 minutes, an energy of 100 J/cm2, a power of 100 mV/cm2 , once every 7 days, is an effective and harmless method of treating GSM.

Photodynamic therapy for facial skin cancer developed in the zone of previous radiotherapy (clinical case)

The results of a 13-year clinical observation of a patient after treatment for basal cell carcinoma of the skin of the right cheek Ist cT1N0M0 are presented. The history of the course of the disease is associated with the fact that the patient underwent radiation therapy in early childhood for hemangioma of the lower eyelid of the right eye and right cheek. In 2008, against the background of post-radiation changes in the area of the right cheek, basal cell carcinoma was diagnosed at the Moscow Oncological Research Institute. P.A. Herzen. At the Center for Laser and Photodynamic Diagnostics and Tumor Therapy, the patient underwent organ-preserving PDT treatment. A course of photodynamic therapy (PDT) with 5-aminolevulic acid was carried out. Subsequently, the patient was followed up until 2021 without relapse in the PDT area. In 2016, the patient was diagnosed with a relapse of the disease in the form of a new focus of basal cell carcinoma of the upper eyelid skin on the right Iast cT1N0M0. The patient underwent a course of PDT with a chlorin e6-based photosensitizer. Complete regression of the tumor was achieved, the period of relapse-free follow-up was 5 years.

Photodynamic therapy for preinvasive vaginal cancer.

5592 Background: Photodynamic therapy (PDT) is an effective method for the treatment of various cancers resulting in apoptosis, autophagy and ischemic necrosis of irradiated tissues. The purpose of the study was to analyze the efficacy of PDT for pre-invasive vaginal cancer treatment. Methods: PDT results were studied in 20 patients aged 32-65 years with verified pre-invasive vaginal cancer. All patients received PDT with the Latus diode laser and Photolon or Photolan photosensitizers. The effect was evaluated with extended colposcopy. The criteria for efficiency included normalization of the colposcopic picture and the absence of atypical cells. The sizes of the irradiation fields varied from 1.5 to 2 cm, the number of fields - from 1 to 4, the power density - from 0.1 to 0.17 W/cm2, the light dose - from 40 to 100 J/cm2. The duration of a PDT session varied from 10 to 30 min, depending on the number of irradiation fields. The irradiation field necessarily included an area of normal tissue 3-5 mm surrounding the lesion. 4 to 6 sessions were required to restore the normal layer of stratified squamous epithelium. The antitumor efficacy of PDT was evaluated based on the results of visual observation of changes in the area of the treated pathological foci and information on the presence or absence of clinical symptoms of the disease 1 and 3 months after the treatment (WHO criteria). Results: Complete regression was registered in 100% of patients after 3 months. Repeated courses of PDT were required in cases with a wide spread of pathological foci and the impossibility of their simultaneous irradiation. At follow-up after 1 month, 3 of 20 patients (15%) showed local foci of atypical changes in the epithelium managed with repeated PDT courses. In 6 months, stable remission of the disease clinical symptoms in the treated pathological foci was registered. The results of the cytological study performed 3 months after PDT were normal in 100% patients; no negative changes were registered 6 and 12 months after PDT. Conclusions: The results of PDT in the treatment of patients with pre-invasive vaginal cancer demonstrated its high therapeutic efficacy and a minimal number of adverse reactions, which allows recommending PDT in the treatment of pre-invasive vaginal cancer.

New opportunities in the treatment of cutaneous lymphoid hyperplasia

Here, we present the results of our research regarding the efficacy of photodynamic therapy (PDT) in cutaneous lymphoid hyperplasia (CLH). We observed five patients with CLH. The diagnoses were confirmed both clinically and through laboratory testing. The response to treatment was defined by the index of the modified assessment of the severity of the skin lesions scale (mSWAT). PDT (665 10 nm) with topical photosensitizer application was performed once a week. The PDT course consisted of 4 2 sessions. After the therapy, complete remission was achieved in four patients (80%; mSWAT 95100%) and partial remission in one patient (20%; mSWAT 63%). Thus, PDT proved to be an effective and safe method for treating CLH.

Photodynamic therapy of cancer of large duodenal papilla and extrahepatic bile ducts

The problem of treating patients with malignant neoplasms of the extrahepatic bile ducts and the large duodenal papilla remains relevant due to the growing incidence, high mortality, and a pronounced decrease in the quality of life of patients, despite the radical surgery. The purpose of this study was to evaluate the effectiveness of photodynamic therapy (PDT) in inoperable patients with malignant tumors of these localizations.The study is based on the treatment of 79 patients with adenocarcinoma of large duodenal papilla and extrahepatic bile ducts. 29 patients received palliative bile drainage operations with PDT. 50 patients in the control group only had palliative bile drainage operations. Patients in the study group received from 1 to 3 PDT courses in a year. In total, 29 patients received 52 PDT courses. The tolerance to the method and the life expectancy of patients were evaluated. The median survival of patients who underwent PDT was 18 months (11–60 months); in the control group – 11.5 months. PDT, in combination with bile drainage operation, is an effective method for the treatment of inoperable patients with malignant neoplasms of the extrahepatic bile ducts and the large duodenal papilla in the absence of severe complications and with easy tolerance to therapy by patients. For the treatment and prolongation of life of patients whose radical surgical treatment is associated with a high risk of death, PDT seems to be the best treatment option. Results of PDT treatment for cancer of this localization are comparable with the results of radical surgeries and exceed those for palliative surgeries.

Photodynamic therapy of penile cancer

In this article we submit the case report of a patient with cT1N0M0 penile cancer diagnosis. The patient underwent two courses of photodynamic therapy (PDT) using Fotoditazin photosensitizer (PS) and ATKUS-2 diode laser. The PS was administered at a dose of 1 mg/kg of body weight 2 hours prior to the PDT session. The irradiation parameters were: 662 nm laser wavelength, 200 mW/cm 2 power density and 250 J/cm 2 energy density. In the presented clinical observation, we demonstrated that PDT is an effective and safe treatment method in patients with non-invasive penile cancer. The use of photodynamic therapy allowed preserving the physiological urination, sexual function and achieving a good cosmetic effect.

Successes of photodynamic therapy in treatment of erythroplasia of Queyrat

The review is dedicated to the analysis of the effectiveness of the treatment of erythroplasia of Queyrat (EQ) using photodynamic therapy (PDT). Particular attention is paid to the relationship between EQ and human papillomavirus (HPV) infection. The data of various researchers are presented, confirming the correlation between the development of the EQ and the HPV infection, however, it is noted that due to the small number of studies it is difficult to draw reliable conclusions on the presence and strength of this connection. The mechanisms of PDT involved in the implementation of both the antitumor effect in the treatment of EQ and the antiviral effect against HPV are considered. The data of 12 clinical studies and observations of the results of PDT of the EQ conducted in recent years are analyzed. An analysis of literature data showed that in the treatment of EQ, one of the two photosensitizers is usually used locally: 5-aminolevulinic acid or 5-aminolevulinic acid methyl ester. The treatment parameters in all the analyzed studies were similar: exposure to the ointment for 3–5 hours followed by irradiation with a light dose of 37–105 J/cm 2 . The number of PDT courses in different studies varied from 1 to 19. The effectiveness of treatment varied widely in different studies and clinical observations. Most studies have demonstrated high efficacy of PDT with complete regression in 36–83% (100% in one study) and a relapse-free follow-up period of up to 51 months. However, there were also individual clinical observations of patients in whom the treatment with the method of PDT was ineffective. It is possible that the described results were associated with improperly selected regimes of PDT or a large lesion area. Most authors especially note a very good cosmetic effect and a complete absence of scars after the treatment. Thus, PDT is an effective and promising method for the treatment of EQ that requires, however, a more thorough development of the application regimen and a deeper study of the antitumor and antiviral components of the mechanism of action.

Multi-course photodynamic therapy of basal cell skin cancer of the central face area (clinical study)

The results of an 11-year clinical observation and treatment of a patient with stage II basal cell carcinoma of the face (Т2N0M0) are presented. History of the illness is associated with a long (from 2001 to 2008) inadequate treatment, due to the incorrect diagnosis. After the proper diagnosis was established, from 2008 to 2019 at the Center for Laser and Photodynamic Diagnostics and Tumor Therapy of P.A. Herzen Moscow Oncology Research Center, the patient underwent organ-preserving treatment using the multi-course photodynamic therapy (PDT) and drug targeted therapy. In total, 23 courses of PDT were conducted with photosensitizers of the chlorin series and 5-aminolevulinic acid during this period. Since 2018, the patient is in the process of targeted drug treatment with Vismodegib. In the course of targeted drug treatment, a follow-up examination in 2019 revealed continued growth of the residual tumor, and another course of PDT was carried out. Throughout the observation period, the patient tolerated the treatment well, without complications, with a good quality of life and satisfactory cosmetic effect.

Effectiveness of photodynamic therapy of a patient with early central lung cancer and cystic fibrosis

The authors describe a clinical observation with full clinical effect after multi-course photodynamic therapy of a patient with central lung cancer and cystic fibrosis using Photoditazine. Photoditazine was administered intravenously at a dose of 0.8 mg/kg 2 hours before the irradiation session. Irradiation parameters: power density – 150 mW/cm2, energy density – 200 J/cm2. In total, 3 courses of photodynamic therapy were performed. As a result of the treatment, a complete regression of the tumor was noted. The patient has been under dynamic observation for 2 years after treatment, no relapse was observed.

Successful pregnancy and delivery following selective use of photodynamic therapy in treatment of cervix and vulvar diseases.

Photodynamic therapy has been gaining popularity, particularly among young women. Therefore it is crucial to evaluate PDT for safety and its impact on fertility and delivery of healthy newborns. The study analyzed the PDT treatment of 10 young women, who suffered from diseases of the vulva and cervix. The aim of the analysis was evaluating what impact PDT treatment had on their pregnancies and delivery. 10 patients (22-32 years of age, 25.5 years of age on average) were treated with PDT in 2007-2014. 2 patients suffered from squamous cell hyperplasia, 2 patients from vulvar lichen sclerosus, 1 - genital warts, 1 - VIN I (current terminology: LSIL/Flat condyloma), 2 - CIN III (HSIL), 2 - CIN I (LSIL). The patients underwent photodynamic therapy (PDT). In the course of PDT the 5% 5- aminolevulinic acid was used in gel form three hours before irradiation. The affected areas were irradiated with a halogen lamp PhotoDyn 501 (590-760 nm) during a 10-min radiation treatment. The treatment was repeated weekly for 10 weeks. The median observation time period between the end of therapy and delivery was 3.92 years (2-7 years). None of the patients suffered from infertility. All patients gave birth to healthy, full-term infants. In case of one pregnancy cervical cerclage was needed. Two patients were treated for hypothyroidism caused by the Hashimoto disease. One patient had gestational diabetes. Two patients had already given birth to 2 children. Five patients gave birth by caesarean section. Topical PDT selectively used for treating the diseases of the female reproductive organs was applied in our group of patients and proved to be a safe method. It had no apparent negative impact on female fertility and allowed these women to give birth to healthy children.

Evaluation of vulvar leukoplakia photodynamic therapy efficiency by fluorescent diagnostics method with local «Alasens®» photosensitizer application.

Using continuous-pulse irradiation mode application for performing photodynamic therapy sessions to introduce a new method, and conclude results of clinical research focused on vulvar leukoplakia photodynamic therapy efficiency in combination with topical aqueous «Alasens®» solution administration. Seventy patients (average age of 61 years) diagnosed with vulvar leukoplakia disease (2018 ICD-10-CM Diagnosis Code N90.4) were examined. The following values represent doses of combined mode photodynamic therapy session: 12 J/cm2 pulse radiation dose; 3.5 J/cm2 continuous radiation dose. Non-invasive spectroscopic and visual control of drug accumulation in real time was carried out by fluorescence diagnostic method before and after each therapy session. Single-therapy session efficiency was estimated by a fluorescent signal reduction in the pathological region after irradiation, and the direct correlation between photosensitizer photobleaching and disease regression was registered. Photodynamic therapy course included three procedures, with each session applied in 24 -h intervals, and when necessary, an additional course of therapy was applied 60 days afterward. Significant post-treatment results took effect after 2-3 courses with symptom presence reduced or fully regressed depending on the initial severity of the disease. Additionally, side effects and sequelae remained absent in all cases. The result of methods applied during the clinical research period indicate strong potential in utilizing such promising technology to contribute to the possible prevention of malignant transformation and the treatment of vulvar leukoplakia.