The clinical efficacy and influencing factors of HpD-photodynamic therapy in the treatment of high-grade vaginal squamous intraepithelial lesions

Objective: To investigate the efficacy and safety of HpD-photodynamic therapy in the treatment of high-grade vaginal squamous intraepithelial lesions. Methods: Fifteen patients diagnosed by pathology as vaginal HSIL were selected from January 2020 to September 2022. PDT was performed by 630 nm laser 48 h–72 h after intravenous injection of 2.0 mg/kg–2.5 mg/kg hematoporphyrin derivative. The power density is 100 mW/ cm2，the irradiation time is 30 min, and the energy density is 180 J/cm2. The curative effect was evaluated by histopathological biopsy and HPV examination 3–6 months after operation. The numerical pain rating scale (NPRS) system was used to record the intraoperative and postoperative pain. Patient’s satisfaction was self-evaluated during the operation, the adverse reactions and complications were observed at 1 week, 1 month and 3–6 months after operation. Results: 15 patients were treated using PDT. After 3–6 months，8 cases were reported complete remission (CR), 3 cases were reported partial remission (PR) and 4 cases were reported no remission. The effective rate was 73.3%. All 15 patients were high-risk HPV infected and the clearance rate was 26.7% (4/15). 6 patients（40%）had tolerable lower abdominal pain within 1 week after operation, 4 patients (26. 7%) had tolerable lower abdominal pain within 1 week after operation (NPRS was 0. 73 ± 1. 2 and 0. 47 ± 0. 8) and 1 patient had local photosensitive reaction. Conclusions: PDT is effective, safe and non-invasive in the treatment of high squamous intraepithelial lesions of the vagina. It is worthy of clinical promotion and application.