Light and plasma technologies for non-excisional fertility-preserving treatment of cervical and endometrial cancer

Cervical and endometrial cancers can substantially compromise reproductive potential in women who wish to preserve fertility.Although fertility-sparing surgery for cervical cancer, such as conization or trachelectomy, can maintain the uterus, it may reduce cervical length and weaken cervical support, increasing the risk of adverse obstetric outcomes.In endometrial cancer, standard surgery usually requires hysterectomy, resulting in irreversible loss of fertility, while conservative hormonal therapy is restricted to carefully selected low-risk patients and requires repeated surveillance.Therefore, non-excisional local therapies capable of eliminating malignant or premalignant cells while preserving uterine and cervical structures are clinically needed.Photodynamic therapy, photothermal therapy, and cold atmospheric or non-thermal plasma therapy have gained attention as potential fertility-preserving approaches.Photodynamic therapy uses light-activated photosensitizers to generate cytotoxic reactive oxygen species, whereas photothermal therapy converts light energy into localized heat through photothermal agents.Cold plasma induces reactive oxygen and nitrogen species with limited thermal injury.This review summarizes the mechanisms, therapeutic materials, preclinical and clinical evidence, limitations, and future perspectives of light-and plasma-based strategies for fertility preservation in cervical and endometrial cancers.