Efficacy and Influencing Factors of Photodynamic Therapy in Treating Cervical Low-Grade Squamous Intraepithelial Lesion

• This retrospective study demonstrated that ALA-PDT could achieve high regression rates of HR HPV associated cervical LSIL. • LSIL regression was achieved in 79.8% of patients at 6 months, increasing to 85.9% at 12 months. HR-HPV clearance rates reached 65.2% at 6 months and 78.8% at 12 months. • For the first time this study demonstrated that HPV vaccination was associated with significantly enhanced clearance of subsequent breakthrough infections and improved 6-month LSIL/HPV outcomes, suggesting synergistic benefits. To evaluate the efficacy of photodynamic therapy (PDT) in treating cervical low-grade squamous intraepithelial lesions (LSIL) and to identify factors influencing treatment outcomes. We conducted a retrospective study of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) treatment of 93 women diagnosed with cervical LSIL and concurrent high-risk human papillomavirus (HR-HPV) infection. Follow-up assessments of HPV, cytology and colposcope were performed at 6 and 12 months. At the 6-month follow-up, pathological regression was observed in 79.8% (71/89) of patients and HR-HPV in clearance 65.2% (58/89). By 12 months the regression rate increased to 85.9% (73/85) and HR-HPV clearance rate to 78.8% (67/85), while one patient experienced disease progression. Analysis indicated that HPV vaccination history was associated with LSIL reversal and HPV clearance at 6 months (P < 0.05). ALA-PDT is effective and well-tolerated for the treatment of LSIL patients with HR-HPV infection, with outcomes influenced by prior HPV vaccination. The combination of vaccination and PDT may yield synergistic therapeutic benefits for cervical lesions.