Photodynamic Therapy in Endometrial Cancer: Current Evidence and Future Perspectives

Alicja Gruna; Katarzyna Szalacha; Krzysztof Górecki; Maciej Kozłowski; Marcel Likus; Michał Pawlików; Natalia Kobylarz; Paulina Wyszkowska; Wiktor Marek; Maria Lizner

doi:10.12775/QS.2026.78.76637

Authors

Alicja Gruna Uniwersytet Rzeszowski https://orcid.org/0009-0005-3729-4457
Katarzyna Szalacha Uniwersytet Rzeszowski https://orcid.org/0009-0009-0647-6441
Krzysztof Górecki Uniwersytet Rzeszowski https://orcid.org/0009-0003-3242-8896
Maciej Kozłowski Uniwersytet Rzeszowski https://orcid.org/0009-0000-5135-9994
Marcel Likus Uniwersytet Rzeszowski https://orcid.org/0009-0008-7010-9542
Michał Pawlików Uniwersytet Rzeszowski https://orcid.org/0009-0005-3274-6346
Natalia Kobylarz Uniwersytet Rzeszowski https://orcid.org/0009-0002-9819-8029
Paulina Wyszkowska Uniwersytet Rzeszowski https://orcid.org/0009-0008-2921-384X
Wiktor Marek Uniwersytet Rzeszowski https://orcid.org/0009-0006-2562-2617
Maria Lizner Uniwersytet Rzeszowski https://orcid.org/0009-0005-9015-8120

DOI:

https://doi.org/10.12775/QS.2026.78.76637

Keywords

endometrial cancer, photodynamic therapy, photosensitizers, fertility preservation, hysteroscopy, molecular classification, immunogenic cell death, photodynamic diagnosis

Abstract

Background. Endometrial cancer is a common gynecologic malignancy with substantial

biological heterogeneity. Photodynamic therapy (PDT) is a local treatment in which a

photosensitizer, light and molecular oxygen generate reactive oxygen species and tumor

injury. The accessibility of the endometrial cavity makes PDT a potentially attractive organ-

preserving approach.

Aim. To critically summarize current evidence on PDT in endometrial cancer, focusing on

clinical and preclinical studies, photosensitizers, mechanisms, fertility-sparing applications,

limitations and emerging strategies.

Materials and methods. A narrative literature review was conducted using

PubMed/MEDLINE and additional bibliographic sources. Searches addressed PDT,

endometrial cancer, photosensitizers, 5-aminolevulinic acid, hypericin, hematoporphyrin

derivatives, radachlorin, nanoparticles, hypoxia and immunogenic cell death, with particular

attention to publications from 2024–2026.

Results. Direct clinical evidence remains limited. Small clinical series and fertility-preserving

reports suggest that PDT may achieve local responses in selected early-stage tumors.

Preclinical studies demonstrate phototoxic effects of several photosensitizers, including

hematoporphyrin derivatives, hypericin, 5-aminolevulinic acid/protoporphyrin IX and

radachlorin. Current research focuses on tumor selectivity, light delivery, oxygen availability,

nanocarriers and immunogenic cell death. No large randomized trials have established PDT as

standard treatment.

Conclusions. PDT should currently be considered an investigational, potentially organ-

preserving modality rather than a replacement for surgery or systemic therapy. Its strongest

rationale is in selected localized disease accessible to light. Future studies should address

2molecular risk classification, standardized hysteroscopic protocols, dosimetry, fertility

outcomes, long-term surveillance and combinations with systemic therapies.

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Photodynamic Therapy in Endometrial Cancer: Current Evidence and Future Perspectives

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Photodynamic Therapy in Endometrial Cancer: Current Evidence and Future Perspectives

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