Comparison of 5-ALA-PDT and LEEP for cervical squamous intraepithelial neoplasia: A systematic review and meta-analysis

Abstract

Objectives: The objective of the study was to assess the function of 5-aminolevulinic acid photodynamic therapy (5-ALA-PDT) versus loop electrosurgical excision procedure (LEEP) in the treatment of cervical squamous intraepithelial neoplasia (CIN).

Methods: Following the PICO guidelines, a comprehensive literature review was carried out according to data from PubMed, Embase, and other related databases. Notably, only the randomized controlled trials (RCT) and retrospective clinical trials were included in this study and then analyzed. And the primary results were composed of the pathological regression rate, residual lesion rate, and HPV clearance rate at 3-6 months.

Results: The detailed review and meta-analysis in this study were composed of 7 relevant studies. A total of 851 patients were assigned in this study: 316 for the ALA-PDT group and 535 for the LEEP group. In the comparison of ALA-PDT and LEEP for the treatment of CIN, it showed no significant difference within the pathological regression and residual lesion. However, the HPV clearance of the ALA-PDT group was superior to the LEEP group.

Conclusions: Both of the two groups in this study showed substantial clinical effectiveness in the management of CIN. Additionally, ALA-PDT showed a superior HPV clearance rate within patients with CIN. However, the meta-analysis, which included only one RCT, requires cautious interpretation of the results, and more RCT are needed to confirm these findings.

Keywords: 5-ALA-PDT; Cervical squamous intraepithelial neoplasia; Human papillomavirus; LEEP; Meta analysis.