Photodynamic therapy combined with carbon dioxide laser for low-grade vaginal intraepithelial neoplasia: A retrospective analysis

Yao, Hongxia; Zhang, Haiyan; Pu, Xiaowen; Shi, Lei; Zhang, Yunfeng; Wang, Peiru; Zhang, Guolong; Zhou, Zhongxia; Zhou, Weiqiang; Wang, Xiuli

doi:10.1016/j.pdpdt.2020.101731

Cited by 15 publications

(3 citation statements)

References 17 publications

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“…Although CO 2 laser vaporization is established as the standard procedure for the conservative treatment of VAIN, it is difficult to cover multipoint lesions, while PDT can be extensive and repeated. On the other hand, the laser may cause serious side effects, such as bleeding, adhesion, and “dead angle” [27]. The safety and tolerability of STBF‐PDT were demonstrated in this study.…”

Section: Discussionmentioning

confidence: 60%

A chlorin e6 derivative‐mediated photodynamic therapy for patients with cervical and vaginal low‐grade squamous intraepithelial lesions: a retrospective analysis

Yao

Jia

Zhou

et al. 2022

Transl Biophotonics

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Cervical and vaginal low‐grade squamous intraepithelial lesions (LSIL) are associated with persistent human papillomavirus infections, and require an efficacious non‐invasive treatment such as photodynamic therapy due to anatomical characteristics. In this study, we evaluated the clinical efficacy and safety of a chlorin e6 derivative named STBF‐mediated photodynamic therapy (STBF‐PDT) for patients with cervical and vaginal LSIL. A total of 18 patients received STBF‐PDT for 3 to 6 times and followed up for 6 to 12 months; among them, 6 had cervical and vaginal LSIL and 1 had vaginal stump LSIL after hysterectomy for cervical cancer. Results showed the complete remission (CR) rates were 72.22% (13/18), and the HPV remission rates and HPV clearance rates were 88.89% (16/18) and 83.33% (15/18), respectively at 1‐month follow‐up. The CR reached 88.89% and HPV remission rates got 94.44% at the 6‐month follow‐up. There were no recurrence cases so far, and no pain, heaving sensation, scar, deformity, and any other obvious adverse reactions occurred during treatment and follow‐up. In conclusion, STBF‐PDT is an effective, safe, and well‐tolerated method for the treatment of cervical and vaginal LSIL. It may have promising potential for applications in the future.

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Section: Discussionmentioning

confidence: 60%

A chlorin e6 derivative‐mediated photodynamic therapy for patients with cervical and vaginal low‐grade squamous intraepithelial lesions: a retrospective analysis

Yao

Jia

Zhou

et al. 2022

Transl Biophotonics

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“…In a study by Yao et al, which included 40 patients with vaginal LSIL and persistent hr-HPV infection, the complete remission rates were 65% in the CO 2 laser group and 85% in the CO 2 laser+PDT group (p>0.05). Remission rates of hr-HPV were 25% in the CO 2 laser group and 95% in the CO 2 laser+PDT group (p<0.05) at 1 year after treatment 109 …”

Section: Methodsmentioning

confidence: 92%

“…Remission rates of hr-HPV were 25% in the CO 2 laser group and 95% in the CO 2 laser+PDT group (p<0.05) at 1 year after treatment. 109…”

Section: Combination Therapiesmentioning

confidence: 99%

The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) Consensus Statement on the Management of Vaginal Intraepithelial Neoplasia

Kesić

Carcopino

Preti

et al. 2023

J Low Genit Tract Dis

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The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) developed consensus statements on pre-invasive vulvar lesions in order to improve the quality of care for patients with vaginal intraepithelial neoplasia (VaIN). The management of VaIN varies according to the grade of the lesion: VaIN 1 (low grade vaginal squamous intraepithelial lesions (SIL)) can be subjected to follow-up, while VaIN 2–3 (high-grade vaginal SIL) should be treated. Treatment needs individualization according to the patient’s characteristics, disease extension and previous therapeutic procedures. Surgical excision is the mainstay of treatment and should be performed if invasion cannot be excluded. Total vaginectomy is used only in highly selected cases of extensive and persistent disease. Carbon dioxide (CO 2 ) laser may be used as both an ablation method and an excisional one. Reported cure rates after laser excision and laser ablation are similar. Topical agents are useful for persistent, multifocal lesions or for patients who cannot undergo surgical treatment. Imiquimod was associated with the lowest recurrence rate, highest human papillomavirus (HPV) clearance, and can be considered the best topical approach. Trichloroacetic acid and 5-fluorouracil are historical options and should be discouraged. For VaIN after hysterectomy for cervical intraepithelial neoplasia (CIN) 3, laser vaporization and topical agents are not the best options, since they cannot reach epithelium buried in the vaginal scar. In these cases surgical options are preferable. Brachytherapy has a high overall success rate but due to late side effects should be reserved for poor surgical candidates, having multifocal disease, and with failed prior treatments. VaIN tends to recur and ensuring patient adherence to close follow-up visits is of the utmost importance. The first evaluation should be performed at 6 months with cytology and an HPV test during 2 years and annually thereafter. The implementation of vaccination against HPV infection is expected to contribute to the prevention of VaIN and thus cancer of the vagina. The effects of treatment can have an impact on quality of life and result in psychological and psychosexual issues which should be addressed. Patients with VaIN need clear and up-to-date information on a range of treatment options including risks and benefits, as well as the need for follow-up and the risk of recurrence.

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Efficacy of non-invasive photodynamic therapy for female lower reproductive tract diseases associated with HPV infection: a comprehensive meta-analysis

Hua

Zhang

2023

Lasers Med Sci

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Photodynamic therapy combined with carbon dioxide laser for low-grade vaginal intraepithelial neoplasia: A retrospective analysis

Cited by 15 publications

References 17 publications

A chlorin e6 derivative‐mediated photodynamic therapy for patients with cervical and vaginal low‐grade squamous intraepithelial lesions: a retrospective analysis

A chlorin e6 derivative‐mediated photodynamic therapy for patients with cervical and vaginal low‐grade squamous intraepithelial lesions: a retrospective analysis

Efficacy of non-invasive photodynamic therapy for female lower reproductive tract diseases associated with HPV infection: a comprehensive meta-analysis

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