Efficacy and Safety of Photodynamic Therapy for Cervical Intraepithelial Neoplasia and Human Papilloma Virus Infection: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2018 May 26

PMID 29794788

Citations 14

Authors

Wenjia Zhang

Aijia Zhang

Wende Sun

Ying Yue

Hong Li

Affiliations

Soon will be listed here.

Abstract

Background: We sought to conduct a systemic review and meta-analysis of randomized clinical trials to assess the efficacy and safety of photodynamic therapy (PDT) in cervical intraepithelial neoplasia (CIN) and cervical human papilloma virus (HPV) infection.

Methods: The Medline, EMBASE, and Cochrane Central Register databases were searched using relevant keywords for entries up to May 1, 2017, irrespective of year of publication. The language was restricted to English. Randomized clinical trials and qualitative studies comparing PDT and placebo for CIN or HPV-positive patients were included. We assessed the evidence quality using a risk of bias graph in RevMan V5.3 and the Grading of Recommendations Assessment, Development, and Evaluation scoring system.

Results: Of the 168 studies identified, only 4 RCTs met the inclusion criteria for meta-analysis. In all, 292 and 141 patients received PDT or placebo, respectively. PDT significantly increased the complete remission rate (CRR) among those with CIN (odds ratio [OR]: 2.51 [1.23-5.12]; P = .01) and HPV infection (OR: 3.82 [1.91-7.65]; P = .0002). The adverse events rate (AER) for PDT was greater than that for placebo (OR: 13.32 [4.44, 40.02]; P < .00001). The overall evidence quality was very low. Similarly, in a systematic review including 21 qualitative records, the CRRs for CIN patients with PDT and cervical HPV infection patients with PDT were 82.0% and 77.5%, respectively. The AER for PDT was 31.6%, which was lower than that observed in our meta-analysis (74.6%).

Conclusions: PDT that targets CIN or cervical HPV infection improves the CRR, but slightly compromises safety. Further studies are necessary to identify the most effective and least toxic photosensitizer.

Citing Articles

Topical 5-aminolevulinic acid-mediated photodynamic therapy versus loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia.

Liu Y, Li Y, Wu H, Wang Y, Zeng J, Li H Holist Integr Oncol. 2024; 3(1):56.

PMID: 39618553 PMC: 11604713. DOI: 10.1007/s44178-024-00127-3.

Efficacy and Safety of 5-Aminolevulinic Acid Photodynamic Therapy for Treating Cervical and Vaginal Intraepithelial Neoplasia.

Han Q, Guo H, Wu Z, Shi J, Zhang X Pharmaceutics. 2024; 16(5).

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The efficacy and safety of local 5-aminolevulinic acid-based photodynamic therapy in the treatment of cervical high-grade squamous intraepithelial lesion: a single center retrospective observational study.

Qian J, Wang Y, Wu G, Lu J, Sun L, Xu S Front Oncol. 2024; 14:1390982.

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Innovative Diagnostic and Therapeutic Interventions in Cervical Dysplasia: A Systematic Review of Controlled Trials.

Hecken J, Rezniczek G, Tempfer C Cancers (Basel). 2022; 14(11).

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Enhancement of Conventional and Photodynamic Therapy for Treatment of Cervical Cancer with Cannabidiol.

Razlog R, Kruger C, Abrahamse H Integr Cancer Ther. 2022; 21:15347354221092706.

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