光动力疗法治疗光化性唇炎的疗效：系统评价。

Efficacy of photodynamic therapy in actinic cheilitis: A systematic review.

机构信息

Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai.

出版信息

Photodiagnosis Photodyn Ther. 2022 Jun;38:102782. doi: 10.1016/j.pdpdt.2022.102782. Epub 2022 Feb 24.

DOI:10.1016/j.pdpdt.2022.102782

PMID:35218940

Abstract

BACKGROUND

Photodynamic therapy (PDT) has gradually developed into a promising modality for actinic cheilitis (AC), and many new PDT strategies are emerging. However, comprehensive reviews evaluating the efficacy of PDT strategies for AC are lacking.

OBJECTIVE

To systematically review the safety and efficacy of PDT strategies for AC.

METHODS

A systematic review was conducted using three databases to compare several types of PDT for AC in terms of clinical response (CR), histopathology response (HR), cosmetic result, and adverse events.

RESULTS

A total of 19 studies were included, and 292 subjects were finally enrolled. The complete CR rate of ALA-patch PDT, traditional photodynamic therapy (T-PDT), and daylight photodynamic therapy (DL-PDT) was 80.00% (24/30), 65.14% (114/179), and 76.74% (33/43), respectively. The rate of painless patients was 87.10% (27/31) in DL-PDT, whereas the rate was only 31.25% (15/48) in T-PDT. The rates of moderate and severe local phototoxicity were 47.78% (43/90) in T-PDT, 0.00% (0/23) in DL-PDT, and 21.05% (4/19) in ALA-patch PDT.

CONCLUSION

Published literature suggests that ALA-patch PDT seem to achieve high complete CR rate. Besides, DL-PDT might be a well-tolerated therapy compared with T-PDT and ALA-patch PDT. However, these assumptions are made based on very limited data. It is necessary to conduct a long-term larger sample randomized controlled trial to further evaluate the efficacy and adverse events of various PDT schemes for AC.

摘要

背景

光动力疗法（PDT）已逐渐成为光化性唇炎（AC）的一种有前途的治疗方法，并且不断涌现出新的 PDT 策略。然而，目前缺乏对 AC 的 PDT 策略疗效进行全面评估的综述。

目的

系统评价 PDT 策略治疗 AC 的安全性和有效性。

方法

系统检索 3 个数据库，比较 ALA 贴剂 PDT、传统 PDT（T-PDT）和日光 PDT（DL-PDT）等几种 PDT 策略治疗 AC 的临床疗效（CR）、组织病理学疗效（HR）、美容效果和不良反应。

结果

共纳入 19 项研究，最终纳入 292 例患者。ALA 贴剂 PDT、T-PDT 和 DL-PDT 的完全 CR 率分别为 80.00%（24/30）、65.14%（114/179）和 76.74%（33/43）。DL-PDT 无痛患者比例为 87.10%（27/31），而 T-PDT 中无痛患者比例仅为 31.25%（15/48）。T-PDT 中度和重度局部光毒性发生率为 47.78%（43/90），DL-PDT 中为 0.00%（0/23），ALA 贴剂 PDT 中为 21.05%（4/19）。

结论

现有文献表明，ALA 贴剂 PDT 似乎能达到较高的完全 CR 率。此外，与 T-PDT 和 ALA 贴剂 PDT 相比，DL-PDT 可能是一种耐受性更好的治疗方法。但这些结论是基于非常有限的数据得出的，有必要开展长期、更大样本量的随机对照试验，以进一步评估各种 PDT 方案治疗 AC 的疗效和不良反应。