Photodynamic therapy of cervical intraepithelial neoplasia and cervical cancer

Author:

Lapochkina N. P.1ORCID,Nikiforova N. V.2ORCID,Chikina E. V.3,Kozlov V. A.3,Jalalova P. M.2ORCID,Kustov A. V.4ORCID,Koifman O. I.5ORCID,Berezin D. B.5ORCID

Affiliation:

1. Ivanovo State Medical Academy; LLC MC “Europe”

2. Ivanovo State Medical Academy

3. Ivanovo Regional Oncological Dispensary

4. G.A. Krestov Institute of Solution Chemistry of RAS; Ivanovo State University of Chemistry and Technology

5. Ivanovo State University of Chemistry and Technology

Abstract

Purpose: to study the effectiveness of photodynamic therapy in combination with diathermoelectroconization in the treatment of cervical intraepithelial neoplasia and cervical cancer.Materials and methods. The study included 108 patients aged 33.13 ± 1.18 years. Human papillomavirus was detected in all patients. The study group consisted of 62 patients with cervical diseases. The fi rst subgroup included 28 patients with moderate to severe cervical intraepithelial neoplasia and pT1AN0M0 cervical cancer who underwent diathermoelectroconization and photodynamic therapy. The second subgroup included 34 patients with severe cervical intraepithelial neoplasia who underwent only cervical diathermoelectroconization. The control group included 46 patients with unchanged cervix. To carry out fl uorescent diagnostics and photodynamic therapy, the patients of the fi rst subgroup were intravenously injected with a solution of photosensitizer “Fotoditazin” (“Vetagrand”, Russia) at a dose of 0.8–1.2 mg/kg. Three hours later, using the AFS device (“Polironik”, Russia), fl uorescent diagnostics was performed followed by photodynamic therapy with an ALHT-ELOMED laser (“Elomed”, Russia) in continuous mode. The wavelength was 662 nm, the output power – 3 W, the radiation dose – 200–300 J/cm2 for the cervix and 100–125 J/cm2 – for the cervical canal. All patients underwent complex antiviral therapy.Results. All patients after photodynamic therapy showed complete eradication of human papillomavirus and regression of cervical intraepithelial neoplasia. Morphological studies have shown that the effectiveness of combined treatment of moderate and severe cervical intraepithelial neoplasia, reaching 100 %, was higher than with the use of diathermoelectroconization alone (95 %). There were no recurrences of cervical intraepithelial neoplasia and cervical cancer after combined treatment.Conclusion. Photodynamic therapy of cervical intraepithelial neoplasia and cervical cancer is a highly effective method.

Publisher

Skobelkin State Scientific Center of Laser Medicine

Subject

General Medicine

Reference14 articles.

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2. Filonenko E.V., Serova L.G. Possibilities of photodynamic therapy with radachlorin in the treatment of precancer and initial cancer of the cervix. Photodynamic therapy and photodiagnosis. 2015; 3: 3–8. [In Russ.].

3. Zarochentseva N.V., Belaya Yu.M., Dzhidzhikhiya L.K. Vaccination of cervical cancer and diseases associated with the human papillomavirus: Questions and answers. Russian Bulletin of the Obstetrician-Gynecologist. 2017; 17 (5): 23–28. [In Russ.]. DOI: 10.17116/rosakush201717523-28

4. Trukhacheva T.V., Shlyakhtin S.V., Isakov G.A., Istomin Yu.P. Photolon – a new tool for photodynamic therapy. Review of the results of pharmaceutical, pharmacological and clinical studies. Minsk: Republican Unitary Enterprise Belmedpreparaty; 2009. [In Russ.].

5. Agostinis P., Berg K., Cengel K.A., et al. Photodynamic therapy of cancer: An update. CA Cancer J Clin. 2011; 61 (4): 250–281. DOI: 10.3322/caac.20114

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