Photodynamic therapy in prevention of early cervical cancer HPV-related relapses

• Novikova E.G.
• Trushina O.I.

Abstract

The aim of the study was to evaluate antiviral efficacy of photodynamic therapy (PDT) in prevention of early cervical cancer relapses.

Material and methods. Cervical stump PDT with domestic remedy alasens administration was performed in the second stage of treatment after high cone-shaped cervicectomy that was performed to 60 patients with cr in situ and to 40 women with stage IA1 cervical cancer. Average age of patients was 35.6±3.7 years. Identification and differentiation of human papillomavirus (HPV) DNA was performed by qualitative methods - polymerase chain reaction (PCR) - and quantitative methods (PCR RT, Hybrid Capture II) for viral genome detection. HPV DNA detection in cervical scrapes was an indication for cervical stump PDT with alasens administration (20% ointment) at a dose of 0.1 mg/cm². PDT antiviral efficacy was evaluated according to the following criteria: entire effect - HPV DNA complete eradication, lack of viral load; without effect - lack of all types of HPV DNA eradication and viral load reduction.

Results. HHPV types prevalence was as follows: 16^th - 58.9%, 18^th - 12.8%, 31^st - 10%, 45^th - 7%, 33^rd -4.5%, 35^th - 3.8%, 56^th - 2.6%, 58^th - 0.2% (p<0.05). HPV16 in form of monotype was determined much more often (73%) compared with 18^th (16%), 33^rd (7%) and 45^th (3%) monotypes. HPV DNA complete eradication was achieved in 94% of patients. There was no antiviral effect for the rest 6% of observations. In those cases where viral genotype elimination was not registered, several types of HPV contamination (mainly represented by 16^th and 18^th virus strains) in association with each other or with other types of viruses was notice. Indicator of viral heterocopies average concentration was 1224+86, and 68+34 after treatment. Relapses of the disease developed in 3% of clinical observations.

Conclusions. Cervical stump PDT after organ-preserving treatment provides an expressed antiviral effect, double as preventive measure of virus-associated disease recurrences progression. The developed methodology of cervical stump PDT can be recommended with an antiviral purposes after knife amputation, laser, electro-, radio-wave excision and conization of the cervix, as well as alternative diathermo- and radiocoagulation, cryodestruction, laser vaporization method of cervical papillomavirus infection treatment.

Keywords:cervical cancer, photodynamic therapy, alasense, HPV, viral load, relapse

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