Photodynamic therapy for cervical intraepithelial neoplasia. S. Yamaguchi, H. Tsuda, M. Takemori, S. Nakata, S. Nishimura, N. Kawamura, R. Nishimura; Hyogo Medical Center for Adults, Akashi, Japan; Osaka City General Hospital, Osaka, Japan Abstract: Background: Photodynamic therapy (PDT) is a novel strategy for cervical intraepitherial neoplasia (CIN) that does not effect the surrounding normal tissues due to its tumor selectivity. In this study, we assessed the efficacy and toxicity of PDT for CIN. Methods: Between May 1996 and May 2003, 86 women with a histologic diagnosis of CIN (74: primary CINIII, 4: primary CINII, 8: abnormal cytology after conization of microinvasive carcinoma) were treated by PDT. A 2 mg/kg dose of porfimer sodium (Photofrin II) was administered intravenously at 48 to 60 hours prior to laser therapy. Treatment was performed with irradiation of 100 J/cm2 using an Exicimer Dye Laser (EDL) or a YAG-OPO Laser via a colposcope with an optical path for the laser. For the endocervix, a specially designed intracervical probe was used. After treatment, all patients were hospitalized in a dark room with protection from light. The primary effect of PDT was evaluated 3 months after treatment by colposcopy, cytology, and histologic examination. In 57 patients, HPV typing was performed using a PCR non-radioactive HPV detection system with the HPV L1 open reading frame consensus primers before and after treatment. Outpatient follow-up was done every 2 to 3 months after PDT. Results: The median age of all patients was 30 years (range: 19 to 49 years). A complete response (CR) was eventually achieved in all patients. Within 24 hours of laser treatment, necrosis of the CIN region occurred and atypical cells disappeared. In 53 out of 57 patients (93%), HPV was detected and high-risk HPV (16 +18) was detected in 22 patients before treatment. HPV could not be detected in 74% of HPV-positive patients after treatment. Toxicity was predominantly mild cutaneous photosensitivity (grade 1-2 in 28 patients and grade 3-4 in 1 patient). At present, the median follow-up period is 24.4 months (range: 2.2 to 79.5 months). In three patients, recurrence of CINIII occurred at 23.9, 30.1, 34.6 months after treatment, and they all required surgical management. Conclusions: PDT is not only an effective procedure for CIN, but also for HPV infection. Abstract No: 5031 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.