The effectiveness of photodynamic therapy using 5-aminolevulinic acid in the patients with cervical intraepithelial neoplasia high-grade categories (CIN III)

Cervical intraepithelial neoplasia grade III (CIN III) is a significant precursor to cervical cancer, often requiring invasive treatments impacting reproductive function. Photodynamic therapy (PDT) using 5-aminolevulinic acid (5-ALA) offers a minimally invasive, organ-preserving treatment option for young patients desiring to maintain fertility. This study involved 239 patients with severe cervical dysplasia treated with PDT between 2019 and 2024. Patients received a 20% aqueous solution of 5-ALA applied locally to the cervix prior to three PDT sessions using the Biospek laser (wavelength 630 nm). Treatment was conducted 1.5–3 months after cervical conization. Follow-up evaluations included colposcopy and liquid cytology. 219 patients (92.3%) showed normal cytology (NSIL). Of the 20 patients with persistent abnormal smears, 18 (90%) achieved total regression, while 2 (10%) reduced to CIN I. PDT with 5-ALA is a highly effective and safe organ-preserving treatment for high-grade CIN III, providing excellent therapeutic outcomes and preserving reproductive potential in young patients.