goslasmedЛазерная медицинаLaser Medicine2071-80042686-8644Skobelkin Centre for Laser Medicine - a branch of the Federal Clinical Center for High Medical Technologies, FMBA of Russia10.37895/2071-8004-2021-25-4-51-59goslasmed-759Research ArticleОБЗОРЫREVIEWSПрименение фотодинамической терапии в лечении вульварной интраэпителиальной неоплазии (Обзор)Photodynamic therapy in vulvar intraepithelial neoplasia (а review)ЛевченкоВ. С.LevchenkoV. S.

Левченко Виктория Сергеевна – врач онколог-гинеколог, третье онкологическое отделение

Нижний Новгород

Levchenko Victoria – Oncologist-Gynecologist, 3rd Oncological Department

Nizhny Novgorod

md-victoriyalevchenko@mail.ruИлларионоваН. А.IllarionovaN. A.

Илларионова Наталья Александровна – врач онколог-гинеколог

Нижний Новгород

Illarionova Natalya – Oncologist-Gynecologist

Nizhny Novgorod

КоролеваЕ. Н.KorolevaE. N.

Королева Елена Николаевна – врач онколог-гинеколог, третье онкологическое отделение

Нижний Новгород

Koroleva Elena – Oncologist-Gynecologist, 3rd oncological department

Nizhny Novgorod

ЗиновьевС. В.ZinovievS. V.

Зиновьев Святослав Владимирович – врач онколог-гинеколог, третье онкологическое отделение

Нижний Новгород

Zinoviev Svyatoslav – Oncologist-Gynecologist, 3rd oncological department

Nizhny Novgorod

ГамаюновС. В.GamayunovS. V.

Гамаюнов Сергей Викторович – кандидат медицинских наук

Нижний Новгород

Gamayunov Sergey – Cand. Sc. (Med.)

Nizhny Novgorod

ГБУЗ НО «Нижегородский областной клинический онкологический диспансер»РоссияNizhny Novgorod Regional Clinical Oncology CenterRussian Federation2021170420222545159Copyright © Левченко В.С., Илларионова Н.А., Королева Е.Н., Зиновьев С.В., Гамаюнов С.В., 20222022Левченко В.С., Илларионова Н.А., Королева Е.Н., Зиновьев С.В., Гамаюнов С.В.Levchenko V.S., Illarionova N.A., Koroleva E.N., Zinoviev S.V., Gamayunov S.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://goslasmed.elpub.ru/jour/article/view/759

В обзорной статье представлены возможности применения фотодинамической терапии в лечении пациенток c вульварной интраэпителиальной неоплазией, проанализированы отечественные и зарубежные источники литературы. В настоящие время накоплен некоторый  опыт лечения фоновых, предраковых заболеваний и рака вульвы с помощью фотодинамической терапии. Описано применение раз-  личных фотосенсибилизаторов (5-аминолевулиновая кислота, гематопорфирин, хлорин Е6 и другие), применяется несколько способов  введения фотосенсибилизатора и различные параметры фотодинамического воздействия. Фотодинамическая терапия является неинвазивным современным методом лечения. Данный вид терапии отлично зарекомендовал себя во многих отраслях медицины, демонстрирует широкий спектр своих возможностей, обладает противоопухолевым, антимикробным, антимикотическим, противовирусным,  иммуностимулирующим и многими другими эффектами терапии. При применении фотодинамической терапии возможно сохранение  не только функции, но и целостности органа, отмечены высокие косметические результаты, быстрое восстановление после проведенного  лечения. Однако, несмотря на низкую травматичность и незначительную частоту нежелательных реакций, данные об эффективности  фотодинамической терапии противоречивы. В литературе встречается значительный диапазон заданных параметров для проводимого  лечения и режимов воздействия от 50 до 350 Дж/см2. Данные литературы показывают, что эффективность лечения составляет от 30  до 95 %, а в некоторых случаях достигается 100%-ный результат. Лечение данной патологии с помощью фотодинамической терапии  требует дальнейших исследований и анализа, для того чтобы достоверно утверждать об эффективности. В обзоре выполнен анализ  и других вариантов лечения, их преимущества и недостатки; отмечено, что эффективность других методик остается низкой, с высокой  частотой рецидивов

The authors discuss perspectives for applying photodynamic therapy (PDT) in patients with vulvar intraepithelial neoplasia (VIN); they also  analyze domestic and foreign literature sources. Up to now, some experience on the treatment of background, precancerous conditions and  vulvar cancer with PDT has been obtained. The authors describe application of various photosensitizers (5-aminolevulinic acid, hematoporphyrin, E6 chloride and others) as well as several techniques for photosensitizer administration and various parameters of photodynamic effect.  PDT is a non-invasive modern curative option. This type of therapy has proven to be effective in many directions of medicine; it demonstrates  a wide range of its potentials in antitumor, antimicrobial, antimycotic, antiviral, immunostimulating and many other effects. With PDT technique,  one can preserve not only the function, but also the integrity of the organ; it gives an excellent cosmetic result as well as rapid recovery after  the treatment. However, despite the low traumatic complication rate and low level of adverse reactions, data on PDT effectiveness are contradictory. In literature, there is a signififi cant range of set parameters for treatment and exposure modes from 50 to 350 J/cm2. Literature data  demonstrate that PDT effectiveness in VIN treatment ranges from 30 to 95 %, while in some cases it reaches 100 %. So as to reliably assert  PDT effectiveness in the discussed pathology, further research work is needed. This review analyzes other curative options, their advantages  and disadvantages. The authors underline that effectiveness of other curative modalities is still low with a high rate of relapses.

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The authors declare that there are no conflicts of interest present.