Published in Cancer Detection and Prevention 1999; 23(4):351-355.

5-Aminolevulinic Acid-Mediated Photodynamic Therapy of Lntraepithelial Neoplasia and Human Papillomavirus of the Uterine Cervix - A New Experimental Approach

Franz Wierrani M.D.,a Andreas Kubin, Ph.D.c Rudolf Jindra, Ph.D.,c Michael Henry, M.D.,a Kamran Gharehbaghi M.D.,a Wolfgang Grin, M.D.,a Josef Söltz-Szötz, M.D.,b Werner Grünberger, M.D.,a and Gerhart Alth, M.D.c

Departments of a Obstetrics and Gynecology and b Dermatology Rudolfstiftung Hospital, and c Ludwig Boltzmann Institute for Clinical Oncology and Photodynamic Therapy, Vienna, Austria

Address all correspondence and reprint requests to: Franz Wierrani, M.D., Department of Obstetrics and Gynecology, Rudolfstiftung Hospital, Juchgasse 25, A-1030 Vienna, Austria

ABSTRACT: The aim of this study was to treat patients for ectocervical dysplasia [cervical intraepithelial neoplasia (CIN) grades 1 and 2] and associated human papilloma virus (HPV) infections with photodynamic therapy (PDT). In 20 patients, 5-aminolevulinic acid (5-ALA, 12% w/v) was applied topically with a cervical cap 8 h prior to illumination. A thermal light source (150 W halogen lamp) emitting a broadband red light (total energy: 100 J/cm2 , fluence rate: 90 mW/cm2 ) was used for superficial illumination of the portio. In addition, an Nd:YAG pumped dye laser (652 nm) was used to illuminate the cervical canal (total energy: 50 J/cm2 , fluence rate: 300 mW/cm2). Preliminary results of follow-ups at 1, 3, 6, and 9 months posttherapy showed a cytological improvement in the grading of the PAP smears in 19 patients and the eradication of cervical HPV in 80%. These results demonstrate that ectocervical dysplasia and associated HPV infections can be treated by PDT.

KEY WORDS: 5-aminolevulinic acid, cervical intraepithelial neoplasia, human papilloma virus, photodynamic therapy, portio.