H A Kurwa1, R J Barlow, S Neill. 1. Dermatological Surgery and Laser Unit and Vulval Clinic, St John's Institute of Dermatology, St Thomas' Hospital, London SE1 7EH, U.K.
Abstract
BACKGROUND: Photodynamic therapy (PDT) using topical 5-aminolaevulinic acid (5-ALA) has been suggested as an effective and tissue-conserving method of treating carcinoma in situ of the vulva. OBJECTIVES: To evaluate PDT in patients with vulval intraepithelial neoplasia type III (VIN III). METHODS: Topical PDT was performed in six patients with VIN III. Five of the six patients had persistent disease following treatment with other modalities including 5-fluorouracil cream, cryotherapy, carbon dioxide laser ablation and excision. Each patient was treated once with a fluence of 150 J cm-2 using a broad-band light source (580-740 nm) 4 h after topical application of 20% 5-ALA. Patients were reviewed clinically at 1 month and 6 months after treatment. RESULTS: All of the patients developed initial erythema of treated sites, three with subsequent erosions. All patients had clinically evident persistent VIN III at 1-month review. Five patients have subsequently undergone surgical treatment and one is regularly reviewed. CONCLUSIONS: This small uncontrolled study indicates that, as currently administered, a single episode of topical PDT is not effective in the management of treatment-resistant VIN III.
BACKGROUND: Photodynamic therapy (PDT) using topical 5-aminolaevulinic acid (5-ALA) has been suggested as an effective and tissue-conserving method of treating carcinoma in situ of the vulva. OBJECTIVES: To evaluate PDT in patients with vulval intraepithelial neoplasia type III (VIN III). METHODS: Topical PDT was performed in six patients with VIN III. Five of the six patients had persistent disease following treatment with other modalities including 5-fluorouracil cream, cryotherapy, carbon dioxide laser ablation and excision. Each patient was treated once with a fluence of 150 J cm-2 using a broad-band light source (580-740 nm) 4 h after topical application of 20% 5-ALA. Patients were reviewed clinically at 1 month and 6 months after treatment. RESULTS: All of the patients developed initial erythema of treated sites, three with subsequent erosions. All patients had clinically evident persistent VIN III at 1-month review. Five patients have subsequently undergone surgical treatment and one is regularly reviewed. CONCLUSIONS: This small uncontrolled study indicates that, as currently administered, a single episode of topical PDT is not effective in the management of treatment-resistant VIN III.
Authors: Paul A McCarron; Ryan F Donnelly; Brendan F Gilmore; A David Woolfson; Raymond McClelland; Agnieszka Zawislak; John H Price Journal: Pharm Res Date: 2004-10 Impact factor: 4.200
Authors: Mario Preti; Sarah Igidbashian; Silvano Costa; Paolo Cristoforoni; Luciano Mariani; Massimo Origoni; Maria T Sandri; Sara Boveri; Noemi Spolti; Laura Spinaci; Francesca Sanvito; Eleonora P Preti; Adriana Falasca; Gianluigi Radici; Leonardo Micheletti Journal: Ecancermedicalscience Date: 2015-04-29