High mortality rates and poor quality of life result from the late-stage detection and frequent recurrence of gynecological neoplasms.Background/Objectives: The aim of this study was to conduct a systematic analysis of the energy parameters of photodynamic therapy (PDT) in the treatment of cervical and vulvar lesions, with a focus on stimulating immune responses leading to human papillomavirus (HPV) eradication and lesion regression without adverse effects, such as thermal damage.Methods: A total of 46 peer-reviewed studies published between January 2010 and April 2024 were analyzed. These studies focused on PDT applications for cervical and vulvar lesions, sourced from Google Scholar, Scopus, and Web of Science.Results: Although PDT shows promise, significant limitations exist, such as insufficient consideration of individual tumor characteristics, restricted treatment depths, and the heterogeneous distribution and low selectivity of photosensitizer (PS) accumulation in tumors. Tumor hypoxia further reduces PDT’s effectiveness, and most studies overlook immune system activation, which is crucial for targeting HPV infections and improving antitumor responses.Conclusions: Advancing the research into PDT’s molecular and cellular mechanisms, optimizing the immune response stimulation, and improving the PS and delivery methods could enhance the safety and effectiveness of cervical and vulvar neoplasm treatments. The use of personalized PDT parameters may reduce the side effects and enhance the outcomes for patients suffering from gynecological diseases.
妇科肿瘤的晚期检出与频繁复发导致高死亡率及生活质量低下。本研究旨在系统分析光动力疗法治疗宫颈及外阴病变的能量参数，重点探讨其在激发免疫反应、实现人乳头瘤病毒清除及病灶消退方面的作用，同时避免热损伤等不良反应。方法：对2010年1月至2024年4月期间发表的46篇同行评审研究进行系统分析，这些研究通过Google Scholar、Scopus和Web of Science数据库获取，聚焦于光动力疗法在宫颈及外阴病变中的应用。结果：尽管光动力疗法展现出潜力，但仍存在显著局限性，包括对个体肿瘤特征考量不足、治疗深度有限、光敏剂在肿瘤内分布不均及选择性偏低等问题。肿瘤缺氧环境进一步降低了光动力疗法的疗效，且多数研究忽视了免疫系统激活这一对靶向人乳头瘤病毒感染和增强抗肿瘤反应至关重要的机制。结论：通过深化光动力疗法分子与细胞机制研究、优化免疫反应激发策略、改进光敏剂及其递送方式，可提升宫颈及外阴肿瘤治疗的安全性与有效性。采用个体化光动力疗法参数可能降低副作用，改善妇科疾病患者的治疗效果。
Advances in Photodynamic Treatment of Precancerous and Cancerous Gynecological Diseases
肿瘤(癌症)患者之家