Possibilities of using photodynamic therapy in the treatment of cervical precancers and cancers
Literature data on the main areas of treatment for cervical precancers and cancers are analyzed. Human papillomavirus (HPV) is indicated to be the leading etiological agent in the development of squamous intraepithelial lesions and squamous cervical cell cancer of the cervix. Persistent HPV in the cervical epithelium is largely due to the presence of the virus in the vaginal mucosa. Therefore, it is relevant to develop treatments to achieve viral elimination from the mucous membrane of the genital tract, by taking into account the tropism of HPV to the epithelial cells of this area.Gilyadova A.V., Ishchenko A.A., Apolikhina I.A., Saidova А.S., Shiryaev A.A., Samoilova S.I., Alekseeva P.M., Efendiev K.T., Reshetov I.V.
The promising organ-sparing highly selective treatment for cervical intraepithelial neoplasia is photodynamic therapy (PDT) that is based on the systemic or local administration of special substances, such as photosensitizers, that are affected by laser radiation after their injection into the body. The interaction of photosensitizer molecules and light quanta is accompanied by the formation of reactive oxygen species that damage cells and trigger a cascade of processes leading to the death of tumor cells. At the same time, the tumor cells absorb the photosensitizer more actively than healthy ones, which is responsible for the selective antitumor effect of laser radiation.
The requirements for the ideal photosensitizer are considered. These substances during PDT are administered intravenously or topically as a gel or ointment.
Conclusion: The analysis of the literature data has demonstrated the clinical efficiency of PDT in the treatment of patients with cervical intraepithelial neoplasia and HPV carriers without adverse effects on fertility. PDT contributes to the successful treatment of pathological foci on the cervical mucous membrane; the efficiency and safety of the technique are ensured by tissue selectivity of the effect. During the treatment, the surrounding intact tissues are not damaged, there is no gross scarring or stenosis of the cervical canal; thus, PDT makes it possible to preserve the normal anatomical and functional characteristics of the cervix.
Keywords
cervical cancer
precancerous diseases
photodynamic therapy
photosensitizers
eradication
human papillomavirus
squamous intraepithelial lesions of the cervix
preinvasive cancer
colposcopy
conization
ablation
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Received 24.03.2022
Accepted 28.04.2022
About the Authors
Aida V. Gilyadova, Assistant of the Department of Oncology, Radiotherapy and Plastic Surgery, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University); doctor of the Gynecology Department, Medical and Rehabilitation Center of the Ministry of Health of Russia, aida-benyagueva@mail.ru,https://orcid.org/0000-0003-4343-4813, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Anton A. Ishchenko, PhD, Head of the Clinic of Gynecology, Reproductive and Aesthetic Medicine, Medical and Rehabilitation Center of the Ministry of Health of Russia, ra2001_2001@mail.ru, https://orcid.org/0000-0001-6673-3934, 125367, Russia, Moscow, Ivankovskoe highway, 3.
Inna A. Apolikhina, Dr. Med. Sci., Professor, Head of the Department of Aesthetic Gynecology and Development, V.I. Kulakov NMRC for AG&P, Ministry of Health of Russia; Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Vocational Education, First MSMU, Ministry of Health of Russia (Sechenov University), i_apolikhina@oparina4.ru, https://orcid.org/0000-0002-4581-6295, 117997, Russia, Moscow, Academician Oparin str., 4.
Aina S. Saidova, PhD, obstetrician-gynecologist of the Department of Aesthetic Gynecology and Fetus, V.I. Kulakov NMRC for AG&P, Ministry of Health of Russia,
a_saidova@oparina4.ru; https://orcid.org/0000-0003-3473-3109, 117997, Russia, Moscow, Academician Oparin str., 4.
Artem A. Shiryaev, PhD, oncologist at the Institute of Oncological Cluster named after Prof. L.L. Levshin, I.M. Sechenov First MSMU, Ministry of Health of Russia
(Sechenov University), artemdoc@mail.ru, https://orcid.org/0000-0001-9421-420X, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Svetlana I. Samoilova, Associate Professor of the Department of Oncology, Radiotherapy and Plastic Surgery, N.V. Sklifosovsky Institute of Clinical Medicine,
I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University), sv_samoilova75@mail.ru, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Polina M. Alekseeva, Junior Researcher at the Laboratory of Laser Biospectroscopy, Prokhorov General Physics Institute RAS, alekseeva.polina2012@mail.ru;
https://orcid.org/0000-0003-2716-4606, 119991, Russia, Moscow, Vavilov str., 38.
Kanamat T. Efendiev, Junior Researcher at the Laboratory of Laser Biospectroscopy, Prokhorov General Physics Institute RAS, kanamatius@mail.ru,
https://orcid.org/0000-0002-5864-1172, 119991, Russia, Moscow, Vavilov str., 38.
Igor V. Reshetov, Academician of the RAS, Dr. Med. Sci., Professor, Head of the Department of Oncology, Radiotherapy and Plastic Surgery, N.V. Sklifosovsky Institute
of Clinical Medicine, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University); Director of the Institute of Cluster Oncology
named after Prof. L.L. Levshin, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University), reshetoviv@mail.ru, https://orcid.org/0000-0002-0909-6278, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Corresponding author: Aida V. Gilyadova, aida-benyagueva@mail.ru
Authors' contributions: Gilyadova A.V., Saidova A.S., Shiryaev A.A., Samoilova S.I., Alekseeva P.M., Efendiev K.T. – material collection and processing, writing the text; Ishchenko A.A., Reshetov I.V., Apolikhina I.A. – editing.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The article has been prepared without sponsorship.
For citation: Gilyadova A.V., Ishchenko A.A., Apolikhina I.A., Saidova А.S., Shiryaev A.A., Samoilova S.I., Alekseeva P.M., Efendiev K.T., Reshetov I.V. Possibilities of using photodynamic therapy in the treatment of cervical precancers and cancers
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 5: 35-42 (in Russian)
https://dx.doi.org/10.18565/aig.2022.5.35-42
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