Efficacy of 5-Aminolevulinic Acid Photodynamic Therapy Versus Observation for Cervical Low-Grade Squamous Intraepithelial Lesions with High-Risk HPV Infection

Objectives: This study aimed to evaluate the efficacy of photodynamic therapy (PDT) compared to observation in managing low-grade squamous intraepithelial lesions (LSILs) with high-risk HPV infection. Methods: We conducted a retrospective cohort study involving 608 patients with pathologically confirmed LSILs and Hr-HPV infection, divided into PDT or observation groups based on clinical preference and evaluation. PDT was administered as a routine clinical treatment option at our center. Follow-up at 6 months included HPV testing, cytology, and colposcopy. Results: The PDT group exhibited significantly higher regression rates (92.5% vs. 48.3%) and complete HPV clearance rates (80.8% vs. 37.3%) than the observation group. Adverse effects from PDT were mild and transient, with no cervical scarring or skin photosensitivity observed. Ten patients conceived successfully post-PDT, with five uncomplicated deliveries to date. Conclusions: These findings suggest that PDT is an effective, non-invasive treatment for LSILs with Hr-HPV infection, demonstrating favorable regression and safety profiles while preserving cervical integrity, particularly in reproductive-aged women.