光动力疗法联合CO2激光治疗外阴鳞状上皮内病变的临床疗效观察。

IF 2.6 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-07-31 DOI:10.1016/j.pdpdt.2025.104744

Jingyi Mu , Yunfeng Zhang , Guiqin Chen , Yongjie Li , Yue Wang

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引用次数: 0

摘要

背景：5-氨基乙酰丙酸（5-ALA）光动力疗法（PDT）联合CO2激光治疗外阴鳞状上皮内病变（VSIL）的综合研究资料仍然有限。本研究评估了VSIL联合治疗的疗效和不良反应。方法：本研究为回顾性研究。研究对象为郑州大学人民医院诊断为VSIL的165例患者。根据患者个人选择分为5-ALA PDT组（n = 37）、CO2激光组（n = 78）和5-ALA PDT联合CO2激光组（n = 50）。分析各组患者的一般情况、治疗次数及不良反应。所有患者在治疗后3个月和6个月分别行HPV、TCT和阴道镜检查，评估治疗效果，必要时再次行活检。结果：治疗3个月后，三组外阴低级别鳞状上皮内病变（VLSIL）和外阴高级别鳞状上皮内病变（VHSIL）患者的HPV阴性转阴率和病变完全缓解（CR）率比较，差异均无统计学意义。对于VLSIL， 5-ALA PDT组（51.7%）和联合组（51.9%）在治疗后6个月HPV阴性转阴率均显著高于CO2激光组（27.6%）。对于VHSIL，治疗后6个月，5-ALA PDT组（62.5%）和联合组（60.9%）的HPV阴性转阴率显著高于CO2激光组（25.0%）。然而，复发率在三组之间没有显著差异。与单一治疗组相比，联合治疗组需要更少的治疗时间。CO2激光组不良反应最轻，联合治疗组次之，5-ALA PDT组不良反应更明显。结论：5-ALA PDT联合CO₂激光治疗不仅缩短了总治疗时间，而且提高了治疗效果。因此，它是治疗VSIL的一个很有前途的选择。

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Clinical efficacy of photodynamic therapy combined with CO2 laser in the treatment of vulvar squamous intraepithelial lesions

Background

Comprehensive research data on the combination of 5-aminolevulinic acid (5-ALA) photodynamic therapy (PDT) and CO₂ laser treatment in the management of vulvar squamous intraepithelial lesions (VSIL) remains limited. This study evaluates the efficacy and adverse reactions associated with the combination treatment for VSIL.

Methods

This study was a retrospective study. The subjects were 165 patients diagnosed with VSIL in the People’s Hospital of Zhengzhou University. According to the patients’ personal choice, they were divided into 5-ALA PDT group (n = 37), CO2 laser group (n = 78) and 5-ALA PDT combined with CO2 laser group (n = 50). The general condition, treatment times and adverse reactions of patients in each group were analyzed. All patients underwent HPV, TCT and colposcopy at 3 months and 6 months after treatment to evaluate the therapeutic effect, and biopsy was performed again if necessary.

Results

There was no statistically significant difference in the HPV negative conversion rates and lesions complete remission (CR) rates of both vulvar low-grade squamous intraepithelial lesions (VLSIL) and vulvar high-grade squamous intraepithelial lesions (VHSIL) patients among the three groups at 3 months after treatment. Regarding VLSIL, the HPV negative conversion rates for both the 5-ALA PDT group (51.7 %) and the combination group (51.9 %) were significantly higher than the CO₂ laser group (27.6 %) at six months post-treatment. Regarding VHSIL, the HPV negative conversion rates for the 5-ALA PDT group (62.5 %) and the combination group (60.9 %) were significantly higher than the CO₂ laser group (25.0 %) at 6 months post-treatment. However, recurrence rates did not differ significantly among the three groups. The combination group required fewer treatment sessions compared to the single treatment groups. The CO₂ laser group experienced the mildest adverse reactions, followed by the combined treatment group, while the 5-ALA PDT group exhibited more pronounced reactions.

Conclusion

The integration of 5-ALA PDT with CO₂ laser therapy not only reduces the overall treatment duration but also enhances treatment efficacy. Therefore, it is a promising option for treating VSIL.

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.