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Cancers (Basel). 2022 Jan 02;14(1). doi: 10.3390/cancers14010211.

Phototheranostics of Cervical Neoplasms with Chlorin e6 Photosensitizer.

Cancers

Aida Gilyadova, Anton Ishchenko, Artem Shiryaev, Polina Alekseeva, Kanamat Efendiev, Radmila Karpova, Maxim Loshchenov, Victor Loschenov, Igor Reshetov

Affiliations

  1. University Clinical Hospital No. 1, Levshin Institute of Cluster Oncology, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, 119435 Moscow, Russia.
  2. National Medical Research Center Treatment and Rehabilitation Center, Ministry of Health of the Russian Federation, 125367 Moscow, Russia.
  3. Prokhorov General Physics Institute of the Russian Academy of Sciences, 119991 Moscow, Russia.
  4. Department of Laser Micro-, Nano-, and Biotechnology, Institute of Engineering Physics for Biomedicine, National Research Nuclear University "MEPhI", 115409 Moscow, Russia.

PMID: 35008375 PMCID: PMC8750251 DOI: 10.3390/cancers14010211

Abstract

(1) Purpose: Improving the treatment effectiveness of intraepithelial neoplasia of the cervix associated with human papillomavirus infection, based on the application of the method of photodynamic therapy with simultaneous laser excitation of fluorescence to clarify the boundaries of cervical neoplasms. (2) Methods: Examination and treatment of 52 patients aged 22 to 53 years with morphologically and cytologically confirmed mild to severe intraepithelial cervix neoplasia, preinvasive, micro-invasive, and squamous cell cervix carcinoma. All patients were carriers of human papillomavirus infection. The patients underwent photodynamic therapy with simultaneous laser excitation of fluorescence. The combined use of video and spectral fluorescence diagnostics for cervical neoplasms made it possible to control the photodynamic therapy process at all stages of the procedure. Evaluation of the photodynamic therapy of intraepithelial cervical neoplasms was carried out with colposcopic examination, cytological conclusion, and morphological verification of the biopsy material after the photodynamic therapy course. The success of human papillomavirus therapy was assessed based on the results of the polymerase chain reaction. (3) Results. The possibility of simultaneous spectral fluorescence diagnostics and photodynamic therapy using a laser source with a wavelength of 660 nm has been established, making it possible to assess the fluorescence index in real-time and control the photobleaching of photosensitizers in the irradiated area. The treatment of all 52 patients was successful after the first photodynamic therapy procedure. According to the PCR test of the discharge from the cervical canal, the previously identified HPV types were not observed in 48 patients. Previously identified HPV types were absent after repeated PDT in four patients (CIN III (

Keywords: cervical cancer; cervical dysplasia; human papillomavirus; organ-preserving treatment; photodiagnostics; photodynamic therapy; phototheranostics

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