Efficacy and safety of photodynamic therapy mediatied by 5-aminolevulinic acid for the treatment of cervical in low-grade squamous intraepithelial lesions combined with high-risk human papillomavirus in patients of childbearing age: A retrospective analysis

• Efficient dual efficacy on HR-HPV clearance and LSIL regression: 5-ALA-PDT achieved progressive HR-HPV clearance and high LSIL regression across multiple sites. • Age-related HPV clearance speed but consistent long-term LSIL efficacy: Younger patients showed significantly higher 3–6 month HPV clearance than older groups, while all age groups had comparable 12-month LSIL regression. • Excellent safety and fertility preservation: 65.82% of patients had no adverse reactions; mild events resolved spontaneously within 5 days. 5-ALA-PDT avoided cervical tissue destruction, maintaining anatomical integrity for fertility. • Alignment with global cervical cancer elimination goals: As a minimally invasive alternative to excisional therapies, 5-ALA-PDT addresses unmet needs of childbearing-age patients, supporting the WHO’s 2030 cervical cancer elimination strategy. This study aimed to assess the efficacy and safety of 5-ALA-PDT for treating cervical LSIL and HR-HPV in women of childbearing age. A retrospective analysis was conducted on 237 patients (aged 20-40 years) who underwent 5-ALA-PDT at Minhang Hospital between 2022 and 2024. The treatment protocol involved topical application of 5-ALA, followed by 635-nm laser therapy at a power of 100 J/cm², administered over a duration of 30 min, and repeated in three sessions, with a spacing of one to two weeks between each session. Follow-up: 1 month (adverse reactions, cervical structure); 3-6/12 months (HR-HPV clearance, LSIL regression). The IBM SPSS 26.0 software was used for the analysis of the data, with a significance level of P