Objective of the study was to evaluate the tolerability and effectiveness of photodynamic therapy (PDT) in patients with vulvar premalignant diseases.Materials and methods. Study was performed in 10 patients on the basis of the National Cancer Institute of Ukraine (Kyiv). Age of patients ranged from 31 to 67 years old (mean age 53.3 ± 3.6 years old). Diagnosis was made on the basis of medical history, complaints and clinical examination of patients, vulvoscopy and results of morphological examination of pathologically altered vulvar tissues. A drug of the chlorine series “Photolon” (RUE “Belmedpreparaty”, Republic of Belarus) in doses from 1 to 2.5 mg/kg was used as a photosensitizer (FS). Photoirradiation of pathologically altered foci was performed 3–4 hours after the end of the FS infusion using a laser coagulator universal “Lika-surgeon” (“Photonics Plus”, Ukraine, λ = 660 nm) with a radiation power of 0.4 W in exposure doses of 100 up to 150 J/cm2. PDT tolerability was assessed basing on the frequency and severity of adverse reactions (CTCAE, version 3.0). PDT effectiveness was assessed basing on the presence/absence of complaints, data from visual observation of changes in the area of treated lesions and morphological examination data at 3 and 6 months after treatment (WHO criteria).Results. No serious adverse reactions associated with FS infusion and PDT session were observed: no allergic reactions (Quincke’s edema, urticaria, drop in blood pressure, bronchospasm), no symptoms of skin phototoxicity. There was remission of clinical symptoms (itch in the area of vulva) in the treated pathological centers and high frequency of clinical and morphological regressions in the control observation terms of patients.Conclusion. Obtained results indicate the relevance and prospects of further researches in the field of laser technology and PDT as options for organ-preserving treatment of vulvar premalignant diseases

This review article discusses the key aspects of the use of laser technologies, namely, laser vaporization (LV) and photodynamic therapy (PDT), in the treatment of patients with cervical intraepithelial neoplasia (CIN). The authors analyzed and systematized the foreign experience of these methods of treatment, their indications and contraindications, as well as the advantages over traditional approaches to the treatment of this pathology. The main advantages of the LV are the possibility of complete evaporation of the pathological focus, visual control over the depth of tissue destruction, the absence of prolonged edema and cicatricial deformities, which allows maintaining the integrity of the cervix and its reproductive function. Despite the low trauma and low frequency of adverse reactions, the data on the effectiveness of LV are quite contradictory and, according to various authors, vary from 50% to 98%. To date, there is a significant amount of accumulated experience in the use of PDT with various photosensitizing agents (5-aminolevulinic acid (5-ALA), hematoporphyrin and chlorin and their derivatives) in the treatment of patients with CIN. The main advantages of the PDT are minimal toxicity to the surrounding normal tissues due to the selective accumulation of photosensitizer in pathological tissues, a low risk of severe pain syndrome, the absence of mechanisms of primary and acquired resistance, the possibility of an outpatient treatment session, the possibility of combining with other methods of therapeutic action, the absence of limiting cumulative doses of photosensitizers and light exposure, the possibility of multiple repetitions of the session, good cosmetic results and the possibility of implementing an organ-preserving method of treatment. The obtained results indicate good tolerability of the method (no severe adverse reactions) and a fairly high efficiency of PDT: the frequency of complete regressions varies from 30% to 67% - for application forms of 5-ALA and from 90% to 98.1% - for hematoporifirin and chlorin photosensitizers. Thus, LV and PDT can be considered safe and effective treatment options for patients with CIN.