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Photodynamic therapy using meta ‐tetrahydroxyphenylchlorin (Foscan ® ) for the treatment of vulval intraepithelial neoplasia
Author(s) -
Campbell S.M.,
Gould D.J.,
Salter L.,
Clifford T.,
Curnow A.
Publication year - 2004
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.2004.06197.x
Subject(s) - medicine , dermatology , library science , computer science
Summary Background Photodynamic therapy (PDT) has unique properties which make it suitable for the local treatment of superficial epithelial disorders; it has been suggested as a useful treatment for carcinoma in situ of the vulva. Objectives To evaluate the effect of the systemic photosensitizing agent meta ‐tetrahydroxyphenylchlorin (mTHPC or temoporfin; Foscan ® , Biolitec, Edinburgh, U.K.) in vulval intraepithelial neoplasia type III (VIN III). Methods PDT using mTHPC was performed in six patients with VIN III. A dose of 0·1 mg kg −1 body weight mTHPC was injected intravenously and the area of VIN irradiated 96 h later with 652‐nm light from a diode laser. Patients were reviewed 1 week, 6 months and 2 years following treatment. Results Patients experienced only minimal pain from the initial treatment but two patients subsequently developed severe pain at the treated site for up to 2 weeks following PDT. All patients developed oedema and slough formation at the treated site and one patient developed cellulitis. At 6 months two patients had developed small recurrences of VIN at the original site and one patient had an area of VIN at a new site. These were treated either with further PDT or with a small excision. At 2 years there was no recurrence of VIN at the original site in all patients reviewed. Conclusions This small case series demonstrates that mTHPC‐PDT is a useful initial treatment for VIN III. It is relatively selective, shows good cosmesis and conserves form and function. This is a major advantage over surgery. Repeat treatments are also possible, which is important in a condition such as VIN, which tends to be multifocal. Systemic mTHPC‐PDT appears to have an advantage over topical 5‐aminolaevulinic acid‐PDT as the photosensitizer is distributed widely in areas of disease and consequently identifies foci which may not be apparent clinically but become evident when illuminated.