Abstract
Relevance According to Globocan 2020, cervical cancer is the 4th most common type of cancer among women worldwide and ranks 2nd among women of reproductive age (15–49 years). HPV is the primary cause of this disease. Objective To evaluate the effectiveness of systemic PDT in women with high-risk HPV. Materials and Methods The study presents the treatment outcomes of 150 women: 125 (87%) with LSIL and 25 (13%) with HSIL, all with positive PCR results for HPV. The treatment was conducted at the Hospital of the Medical Center of the Administrative Department of the President of Kazakhstan. Participants were aged 19 to 48 years. The PDT procedure included four stages: 1. Administration of a photosensitizer (PS), a chlorin-based drug E6-Photolon, at a concentration of 1.2 mg/kg body weight. 2. Photomodification of blood (PMB) through intravenous laser blood irradiation under the influence of the PS. 3. Fluorescent diagnostics (FD) using an AFS emitter (405 nm). 4. Laser photoactivation of the cervical canal with a 4 cm diffuser and vaginal portion of the cervix (300 J/cm²) using the Lahta-Milon laser apparatus (662 nm). 5. The procedure concluded with fluorescent monitoring. Results Treatment effectiveness was assessed by the absence of dysplasia in cytology results, a negative HPV test, and a normal colposcopic picture. Among women with HSIL, HPV prevalence was as follows: type 16 – 14 cases (47%), type 31 – 5 cases (17%), and other types did not exceed 14%. For women with LSIL, the prevalence was: type 16 – 64 cases (29%), type 31 – 20 cases (9%), and other types did not exceed 5%. Conclusions The study revealed that HPV types 16 and 31 are the most prevalent. The systemic approach using combined PDT treatment proved to be a highly effective and organ-preserving method for managing HPV-associated dysplasia. It surpasses traditional therapeutic methods and contributes to the full medical and social rehabilitation of women.