Comparative efficacy of topical 5-aminolevulinic acid versus Hiporfin photodynamic therapy in HPV-positive cervical intraepithelial neoplasia grade II

While both ALA-PDT and HPF-PDT demonstrate comparable and high efficacy for CIN2, their risk-benefit profiles are distinct. HPF-PDT is associated with a clinically significant risk of cervical adhesions and potentially burdensome, prolonged systemic photosensitivity. Therefore, for patients without endocervical involvement, ALA-PDT presents a superior safety profile and should be considered the preferred PDT modality. The role of HPF-PDT should be carefully re-evaluated and likely reserved for select cases where lesion location justifies its additional risks. Conservative management remains a viable option with a high regression rate under close surveillance.