A meta-analysis of photodynamic therapy in the treatment of cervical intraepithelial neoplasia: Based on randomized controlled trials

OBJECTIVE: To systematically evaluate the efficacy and safety of photodynamic therapy (PDT) for HPV-infected cervical intraepithelial neoplasia (CIN) based on randomized controlled trials (RCTs). METHODS: A systematic search was performed across PubMed, EMBASE, Web of Science, and the Cochrane Library from 2000 to 2025, targeting RCTs that compared PDT with standard conization methods or placebo. The primary outcomes assessed included histopathological response, human papillomavirus (HPV) clearance, and the rate of adverse reactions. The quality of the included RCTs was evaluated using the Cochrane Collaboration's RevMan 5.4.1 tool and meta-analysis was conducted to pool effect sizes. RESULTS: Of 270 retrieved records, 6 eligible RCTs involving 973 patients were included. Meta-analysis showed that PDT significantly improved lesion remission rate (OR = 2.27, 95% CI = [1.66, 3.11], I²=0, P < 0.05) and HPV clearance rate (OR = 1.99, 95% CI = [1.32, 2.99], I²=0, P = 0.05). No statistically significant difference in adverse reaction rate was observed between the two groups (P>0.05). CONCLUSION: Based on the pooled data of 6 RCTs, PDT is an effective and safe therapeutic option for HPV-infected CIN, as it enhances lesion remission and HPV clearance without substantially increasing adverse reactions.