Department of Pharmaceutics, College of Medicine, Jiaxing University, Jiaxing, China.
Department of Experimental Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
J Eur Acad Dermatol Venereol. 2019 Jul;33(7):1369-1377. doi: 10.1111/jdv.15599. Epub 2019 Apr 23.
Since the early '80s, the pulsed dye laser has been the standard treatment tool for non-invasive port wine stain (PWS) removal. In the last three decades, a considerable amount of research has been conducted to improve clinical outcomes, given that a fraction of PWS patients proved recalcitrant to laser treatment. Whether this research actually led to increased therapeutic efficacy has not been systematically investigated.
To analyse therapeutic efficacy in PWS patients globally from 1986 to date.
PubMed was searched for all available PWS trials. Studies with a quartile percentage improvement scale were included, analysed and plotted chronologically. Treatment and patient characteristics were extracted. A mean clearance per study was calculated and plotted. A 5-study simple moving average was co-plotted to portray the trend in mean clearance over time. The data were separately analysed for multiple treatment sessions in previously untreated patients.
Sixty-five studies were included (24.3% of eligible studies) comprising 6207 PWS patients. Of all patients, 21% achieved 75-100% clearance. Although a few studies reported remarkably good outcomes in a subset of carefully selected patients, there was no upward trend over time in mean clearance.
The efficacy of PWS therapy has not improved in the past decades, despite numerous technical innovations and pharmacological interventions. With an unwavering patient demand for better outcomes, the need for development and implementation of novel therapeutic strategies to clear all PWS is as valid today as it was 30 years ago.
自 20 世纪 80 年代初以来，脉冲染料激光一直是治疗非侵入性葡萄酒色斑（PWS）的标准治疗工具。在过去的三十年中，已经进行了相当多的研究来改善临床结果，因为一部分 PWS 患者对激光治疗有抗性。这些研究是否确实提高了治疗效果尚未进行系统研究。
分析 1986 年至今全球 PWS 患者的治疗效果。
在 PubMed 上搜索所有可用的 PWS 试验。纳入了使用四分位数百分比改善量表的研究，并进行了分析和按时间顺序绘制。提取治疗和患者特征。计算每个研究的平均清除率并进行绘制。同时绘制 5 项研究的简单移动平均值，以描绘随时间推移的平均清除率趋势。对未治疗患者的多次治疗进行了单独分析。
共纳入 65 项研究（占合格研究的 24.3%），包括 6207 例 PWS 患者。所有患者中，21%达到 75-100%清除率。尽管少数研究报告了一些经过精心挑选的患者亚组的显著良好结果，但平均清除率并未随时间呈上升趋势。
尽管有许多技术创新和药物干预措施，但过去几十年 PWS 治疗的疗效并未提高。由于患者对更好疗效的需求坚定不移，因此今天与 30 年前一样，需要开发和实施清除所有 PWS 的新治疗策略。
