Nissen Christoffer V, Heerfordt Ida Marie, Wiegell Stine R, Mikkelsen Carsten S, Wulf Hans Christian
Department of Dermatology D92 , Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark.
Acta Derm Venereol. 2017 May 8;97(5):617-621. doi: 10.2340/00015555-2612.
The efficacy of photodynamic therapy (PDT) with methyl aminolevulinate is reduced when treating actinic keratosis (AK) on the extremities in comparison with the face and scalp. Studies indicate that PDT efficacy can be improved by combining PDT with other treatment modalities. This randomized intra-individual study investigated whether pretreatment with topical 5% 5-fluorouracil (5-FU) enhanced the treatment efficacy of daylight-mediated PDT in 24 patients with AKs on the hands. One hand of each patient was given 7 days of pretreatment with 5-FU twice daily before daylight-PDT, whereas the other hand was treated with daylight-PDT alone. At 3-month follow-up the overall lesion response rate was significantly higher for the combination of 5-FU and daylight-PDT (62.7%) than for daylight-PDT alone (51.8%) (p = 0.001). Furthermore, pain and erythema in relation to treatment were similar in the 2 groups (p = 1.0 and p = 0.2, respectively). Combination therapy is a safe and effective method to improve daylight-PDT for acral AKs.
与面部和头皮相比，用甲基氨基酮戊酸进行光动力疗法（PDT）治疗四肢光化性角化病（AK）时疗效会降低。研究表明，将PDT与其他治疗方式联合使用可提高其疗效。这项随机个体内研究调查了局部应用5% 5-氟尿嘧啶（5-FU）预处理是否能提高日光介导的PDT对24例手部患有AK的患者的治疗效果。每位患者的一只手在日光PDT前每天两次给予5-FU预处理7天，而另一只手仅接受日光PDT治疗。在3个月的随访中，5-FU与日光PDT联合治疗的总体病变反应率（62.7%）显著高于单纯日光PDT治疗（51.8%）（p = 0.001）。此外，两组治疗相关的疼痛和红斑情况相似（分别为p = 1.0和p = 0.2）。联合治疗是一种安全有效的方法，可改善日光PDT治疗手部AK的效果。
