5-aminolevulinic acid-mediated photodynamic therapy on cervical condylomata acuminata.

Objective: The aim of this study was to evaluate the efficacy of 5-aminolevulinic acid-mediated photodynamic therapy (PDT) on cervical condylomata accuminate (CA) and to determine the ultrastructural changes of the lesion after treatment.

Background Data: Although there are many methods to treat cervical CA, a high recurrence rate and cervical scars are troublesome problems.

Materials And Methods: Forty-eight patients with cervical CA were treated with topical 20% ALA gel followed by PDT through a cylindrical fiber with a wavelength of 630 nm of laser light. The treatment was repeated 7 days later if the lesion had not been removed completely. Eight cases were biopsied before and after treatment, and the biopsied lesions were evaluated by electron microscopy.

Results: After the first PDT treatment, the cervical condylomatous lesions were removed completely in 62.5% (30/48). The complete response (CR) rate was 95.8% (46/48) after three treatments. The recurrence rate was 4.4% at the 12-month follow-up. Electron microscopy revealed that ALA-PDT damaged proliferative keratinocytes of CA lesions while the surrounding normal tissue injury was less damaged.

Conclusions: ALA-PDT is an effective and minimally invasive treatment for cervical CA.