Photodynamic Therapy for Cancer of the Lower Female Genital Tract

Abstract

A new and conservative approach to the management of severe dysplasia and carcinoma in situ of the lower female genital tract was attempted. A total of seven patients who had failed all conventional modalities for cancer of the vulva, vagina, or perianal region were treated with photodynamic therapy (PDT). PDT is an experimental cancer therapy that involves a combination of a tumor-localizing photosensitizer and photoactivating red light, usually from an argon-dye laser system. Of the 45 sites that were treated, 34 were disease-free (76%) as evidenced by negative biopsies at 3 months. Adverse reactions to PDT included a transient cutaneous photosensitivity, due to retention of the photosensitizer in the skin, that usually persisted for 45 to 60 days. Edema, erythema, and necrosis, accompanied by varying levels of pain, occurred in treated sites within 12 to 48 hours of treatment. Based on these initial clinical results, the future of PDT as a modality for cancer of the lower female genital tract appears promising.