Comparison of the efficacy of photodynamic therapy alone and photodynamic therapy after laser pretreatment for high-grade cervical intraepithelial lesions in women of childbearing age: a prospective study

The objective of this study was to compare the effectiveness of photodynamic therapy(PDT)and photodynamic therapy after laser pretreatment for treating cervical high-grade intraepithelial lesions(HSIL) in patients of childbearing age. We conducted a prospective study of 68 women diagnosed with cervical HSIL from January 2022 to June 2024 in Minhang Hospital Affiliated to Fudan University. A total of 60 patients were included in this clinical trial. They were randomly assigned to two groups.30 cases received 5-ALA-PDT, and 30 cases underwent photodynamic therapy after laser pretreatment. All patients were followed up at 6 months and 12 months after treatment, including HPV testing, cytology, and colposcopy examination. 6 months after treatment, the rate of HPV clearance in the PDT after laser pretreatment (86.67%)was marginally higher than the PDT(80.00%)group(P= 0.488). The cure rate after six months of treatment was 86.67% in the PDT after laser pretreatment group and 80.00% in the PDT group (P = 0.488). After 12 months, the HPV clearance rate in the PDT after laser pretreatment group was found to be 93.33%, while the rate in the PDT group was 90.00%(P = 0.640). After 12 months, the cure rate was 90.00% in the PDT after laser pretreatment group and 86.67% in the PDT group (P = 0.688). For patients of reproductive age with cervical HSIL, laser therapy prior to PDT treatment does not result in a substantial enhancement of the cure rate or HPV clearance rate of cervical high-grade intraepithelial lesions.