College of Stomatology, Chongqing Medical University, Chongqing 401147, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China.
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
Photodiagnosis Photodyn Ther. 2019 Dec;28:146-152. doi: 10.1016/j.pdpdt.2019.08.005. Epub 2019 Aug 5.
To assess the impact of photodynamic therapy (PDT) parameters in the management of oral potentially malignant disorders (OPMDs). We conducted a systematic review and meta-analysis of studies that assessed the curative effect of PDT published in PubMed and Embase until Dec 2018. Random or fixed effects models for pooled estimates calculation were used. A pooled estimate calculation revealed that lesion size decreased by 1.38 cm (95% CI: 0.39-2.36) after PDT, and the overall complete response (CR) was 0.52 (95% CI: 0.36-0.68), while partial response (PR) reached 0.82 (95% CI: 0.74-0.88). Subgroup analyses revealed that the lesion response (CR: 0.21 [95% CI: 0.12-0.33]) of oral lichen planus was worse than that of other disease entities. 20% aminolevulinic acid was more effective than other photosensitizers, with the overall CR was 0.68 (95% CI: 0.42-0.86), while the PR was 0.88 (95% CI: 0.76-0.94). Topical use of photosensitizers can yield desirable results, while gargling methylene blue yields poor response (0.82 [95% CI: 0.75-0.88] vs. 0.59 [95% CI: 0.44-0.72], respectively). PDT is an effective treatment modality in the management of OPMDs, the overall efficacy of which is influenced by several factors.
评估光动力疗法 (PDT) 参数在口腔潜在恶性疾病 (OPMDs) 治疗中的作用。我们对 2018 年 12 月前在 PubMed 和 Embase 上发表的评估 PDT 疗效的研究进行了系统回顾和荟萃分析。使用随机或固定效应模型进行汇总估计计算。汇总估计计算显示 PDT 后病变大小缩小 1.38cm（95%CI：0.39-2.36），总完全缓解（CR）为 0.52（95%CI：0.36-0.68），而部分缓解（PR）达到 0.82（95%CI：0.74-0.88）。亚组分析显示口腔扁平苔藓的病变反应（CR：0.21[95%CI：0.12-0.33]）比其他疾病实体差。20%氨基酮戊酸比其他光敏剂更有效，总 CR 为 0.68（95%CI：0.42-0.86），而 PR 为 0.88（95%CI：0.76-0.94）。局部使用光敏剂可以产生理想的效果，而漱口亚甲蓝的反应较差（0.82[95%CI：0.75-0.88]与 0.59[95%CI：0.44-0.72]，分别）。PDT 是治疗 OPMDs 的有效方法，其总体疗效受多种因素影响。
