Evidence map›Paper›PMID 42630880›Full record

ReviewFrontiers in oncology2026

Photodynamic therapy: a promising alternative for high-grade squamous intraepithelial lesion treatment.

Lara Termini, Cristina Paula Castanheira, Noely Paula Cristina Lorenzi, Enrique Boccardo, Telma Lisboa-Nascimento, Maurício S Baptista, Natalia Mayumi Inada, Waleska Kerllen Martins

Abstract readReview
In one paragraph

Review in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Lara TerminiCenter for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo ICESP, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo FMUSP HC, São Paulo, Brazil.
Cristina Paula CastanheiraDepartment of Obstetrics and Gynecology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo FMUSP HC, São Paulo, Brazil.
Noely Paula Cristina LorenziDepartment of Gynecology, Hospital Universitario da Universidade de Sao Paulo, São Paulo, Brazil.
Enrique BoccardoDepartment of Microbiology, Instituto de Ciências Biomédicas, Universidade de Sao Paulo, São Paulo, Brazil.
Telma Lisboa-NascimentoBioengineering Graduate Program, University of Brazil, São Paulo, Brazil.
Maurício S BaptistaDepartment of Biochemistry, Institute of Chemistry, University of Sao Paulo, São Paulo, Brazil.
Natalia Mayumi InadaInstitute of Physics, University of Sao Paulo, São Carlos, Brazil.
Waleska Kerllen MartinsDepartment of Biochemistry, Institute of Chemistry, University of Sao Paulo, São Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cervical cancer, driven by persistent infection with high-risk human papillomavirus (hrHPV), remains a major global health burden. While conventional excisional procedures such as loop electrosurgical excision (LEEP) and conization are effective in treating high-grade squamous intraepithelial lesions (HSIL), which include cervical intraepithelial neoplasia grades 2 and 3 (CIN2 and CIN3, respectively), they are associated with significant risks to cervical integrity and adverse obstetric outcomes. Photodynamic therapy (PDT), particularly using the protoporphyrin IX precursors 5-aminolevulinic acid (5-ALA) and its derivatives, hexyl aminolevulinate (HAL), and methyl aminolevulinate (MAL), has emerged as an alternative and minimally invasive strategy to treat younger women with CIN2. Here, we delineate the cellular and molecular mechanisms that underlie PDT's efficacy in the treatment of cervical lesions. We emphasize the ability of 5-ALA-PDT to selectively target dysplastic cells while preserving the anatomical and functional integrity of the cervix. Central to this therapeutic effect is the modulation of cell death pathways. Specifically, we discuss how PDT counteracts the inhibitory effects of hrHPV on autophagy, thereby facilitating viral clearance and restoring homeostatic immune responses. Furthermore, we delineate the multifaceted cell death modalities orchestrated by 5-ALA-PDT, underscoring their pivotal role in the targeted eradication of hrHPV-transformed cervical cells. Clinical data supporting the reduction of viral load and high regression rates of HSIL are summarized, alongside a critical evaluation of current treatment protocols. Finally, we propose that the future of cervical PDT lies in precision oncology. This highlights the need to focus on the identification of resistance biomarkers and the development of therapeutic strategies that exploit the synergistic combination of PDT with molecular modulators to optimize clinical outcomes and prevent recurrence.

Indexed as

5-aminolevulinic acid (5-ALA)autophagy restorationcervical intraepithelial neoplasia (CIN)high-risk human papillomavirus (hrHPV)hrHPV clearanceprecision oncologyprotoporphyrin IXpyroptosis

Identifiers

PMID42630880
PMCPMC13494708

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.