Possibilities of using photodynamic therapy in the treatment of cervical precancers and cancers


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Abstract

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. 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.

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About the authors

Aida V. Gilyadova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); National Medical Research Center "Treatment and Rehabilitation Center", Ministry of Health of Russia

Email: aida-benyagueva@mail.ru
Assistant of the Department of Oncology, Radiotherapy and Plastic Surgery

Anton A. Ishchenko

National Medical Research Center "Treatment and Rehabilitation Center", Ministry of Health of Russia

Email: ra2001_2001@mail.ru
PhD, Head of the Clinic of Gynecology, Reproductive and Aesthetic Medicine, Medical and Rehabilitation Center of the Ministry of Health of Russia

Inna A. Apolikhina

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: i_apolikhina@oparina4.ru
Dr. Med. Sci., Professor, Head of the Department of Aesthetic Gynecology and Development; Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Vocational Education

Aina S. Saidova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

PhD, obstetrician-gynecologist of the Department of Aesthetic Gynecology and Fetus

Artem A. Shiryaev

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

PhD, oncologist at the Institute of Oncological Cluster named after Prof. L.L. Levshin

Svetlana I. Samoilova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: sv_samoilova75@mail.ru
Associate Professor of the Department of Oncology, Radiotherapy and Plastic Surgery, N.V. Sklifosovsky Institute of Clinical Medicine

Polina M. Alekseeva

A.M. Prokhorov General Physics Institute, Russian Academy of Sciences; National Research Nuclear University "Moscow Engineering Physics Institute (MEPhI)"

Email: alekseeva.polina2012@mail.ru
Junior Researcher at the Laboratory of Laser Biospectroscopy

Kanamat T. Efendiev

A.M. Prokhorov General Physics Institute, Russian Academy of Sciences; National Research Nuclear University "Moscow Engineering Physics Institute (MEPhI)"

Email: kanamatius@mail.ru
Junior Researcher at the Laboratory of Laser Biospectroscopy

Igor V. Reshetov

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: reshetoviv@mail.ru
Academician of the RAS, Dr. Med. Sci., Professor, Head of the Department of Oncology, Radiotherapy and Plastic Surgery, NV. Sklifosovsky Institute of Clinical Medicine, Director of the Institute of Cluster Oncology named after Prof. L.L. Levshin

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