The effect of local photodynamic therapy with 5-aminolevulinic acid in the treatment of vaginal squamous intraepithelial lesions with high-risk HPV infection

Traditional treatments for vaginal squamous intraepithelial lesions (SIL) damage the anatomy and functions of the vagina. This study aims to investigate the efficacy and safety of local 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in treating vaginal SIL. 149 patients with vaginal SIL and receiving ALA-PDT were enrolled. All patients were followed up at 3, 6, 9, and 12 months after the end of treatment. At 6-month follow-up, the complete remission rates in patients with vaginal high-grade SIL and low-grade SIL were both 87.5%. The HPV clearance rates were 65.6% and 50.0%, and reached 72.5% and 80% at 2-year follow-up, respectively. The vaginal stump lesions and a history of hysterectomy were associated with a lower HPV clearance rate. ALA-PDT is an alternative treatment for vaginal SIL. However, the patients with vaginal stump SILs and histories of hysterectomy are at high risk for persistent HPV infection after treatment.