First Dermatology Department, Medical School, Aristotle University, Thessaloniki, Greece.
J Eur Acad Dermatol Venereol. 2010 Aug;24(8):916-20. doi: 10.1111/j.1468-3083.2009.03550.x. Epub 2009 Dec 17.
Actinic cheilitis (AC) may bear the initial and superficial changes of actinically induced squamous cell carcinoma (SCC) and may progress into fully developed SCCs. Early and effective treatment is important.
To assess the clinical and histological long-term outcome in AC after two ALA-PDT sessions.
Patients with histologically proven grade 1 and 2 AC received two ALA-PDT sessions at 2 weeks interval. Subjects with complete clinical response at 3 months were evaluated further clinically and histologically at months 6, 12 and 18. Long-term study outcome was defined as clinical and histological AC recurrence among patients with complete clinical response 3 months after treatment. Cosmetic outcome was assessed by the investigators at the final follow-up visit at 18 months.
Of the 40 patients enrolled, 38 completed the study. Complete clinical response at 3 months was achieved in 26 patients. At 6 months, clinical and histological recurrence occurred in three patients and at 12 months, one more patient showed clinical and histological recurrence. At 18 months, overall clinical recurrence rate was 15.38% (4/26), while overall histological recurrence rate was 34.61% (9/26). Cosmetic outcome was rated as excellent in more than 80% of evaluated cases.
PDT represents a moderately effective treatment modality in AC. Optimization of treatment procedure and protocols is still needed for higher response rates to be achieved. Moreover, the high treatment cost should be given consideration. Further long-term follow-up studies are needed for assessment of clinical and histological very late recurrences that could be expected after PDT.
光化性唇炎（AC）可能具有光诱导鳞状细胞癌（SCC）的初始和浅表变化，并可能进展为完全发育的 SCC。早期和有效的治疗很重要。
评估两次 ALA-PDT 治疗后 AC 的临床和组织学长期结果。
经组织学证实为 1 级和 2 级 AC 的患者接受了两次 ALA-PDT 治疗，间隔 2 周。在 3 个月时完全临床缓解的患者进一步在第 6、12 和 18 个月进行临床和组织学评估。完全临床缓解 3 个月后完全临床缓解的患者的长期研究结果定义为临床和组织学 AC 复发。研究人员在 18 个月的最终随访时评估美容结局。
40 名入组患者中，38 名完成了研究。26 名患者在 3 个月时达到完全临床缓解。在 6 个月时，3 名患者出现临床和组织学复发，在 12 个月时，又有 1 名患者出现临床和组织学复发。在 18 个月时，总临床复发率为 15.38%（4/26），而总组织学复发率为 34.61%（9/26）。在评估的病例中，超过 80%的病例美容结局被评为优秀。
PDT 是 AC 的一种中度有效的治疗方法。为了获得更高的反应率，仍需要优化治疗程序和方案。此外，应考虑到较高的治疗成本。需要进一步的长期随访研究来评估 PDT 后可能出现的临床和组织学非常晚期复发。
