Photodynamic therapy in vulvar intraepithelial neoplasia (а review)

Abstract

The authors discuss perspectives for applying photodynamic therapy (PDT) in patients with vulvar intraepithelial neoplasia (VIN); they also analyze domestic and foreign literature sources. Up to now, some experience on the treatment of background, precancerous conditions and vulvar cancer with PDT has been obtained. The authors describe application of various photosensitizers (5-aminolevulinic acid, hematoporphyrin, E6 chloride and others) as well as several techniques for photosensitizer administration and various parameters of photodynamic effect. PDT is a non-invasive modern curative option. This type of therapy has proven to be effective in many directions of medicine; it demonstrates a wide range of its potentials in antitumor, antimicrobial, antimycotic, antiviral, immunostimulating and many other effects. With PDT technique, one can preserve not only the function, but also the integrity of the organ; it gives an excellent cosmetic result as well as rapid recovery after the treatment. However, despite the low traumatic complication rate and low level of adverse reactions, data on PDT effectiveness are contradictory. In literature, there is a signififi cant range of set parameters for treatment and exposure modes from 50 to 350 J/cm2. Literature data demonstrate that PDT effectiveness in VIN treatment ranges from 30 to 95 %, while in some cases it reaches 100 %. So as to reliably assert PDT effectiveness in the discussed pathology, further research work is needed. This review analyzes other curative options, their advantages and disadvantages. The authors underline that effectiveness of other curative modalities is still low with a high rate of relapses.