Department of Dentistry, Lakhimpur Medical College and Hospital, North Lakhimpur, Assam, India.
Department of Dentistry, Jorhat Medical College and Hospital, Jorhat, Assam, India.
Asian Pac J Cancer Prev. 2024 Sep 1;25(9):2971-2978. doi: 10.31557/APJCP.2024.25.9.2971.
Aminolevulinic acid (ALA) mediated photodynamic therapy (PDT) is considered as an effective treatment option for oral premalignant lesions. ALA is a Food and Drug Administration (FDA) approved second-generation photosensitizer (PS) used both orally as well as topically.
This systematic review aims to evaluate the efficacy of ALA-PDT for the treatment of oral premalignant lesions.
The focused question was, "Is ALA-PDT effective in the treatment of oral premalignant lesions?"A literature search was made in PubMed/Medline and GoogleScholar using different combinations of the following keywords: photodynamic therapy, oral premalignant lesions, oral leukoplakia (OL), erythroplakia, oral erythroleukoplakia (OEL), oral verrucous hyperplasia (OVH); and oral lichen planus (OLP). Review articles, preclinical studies, case-reports, commentaries, letters to the Editor, unpublished articles, studies on photodynamic therapy used in areas other than the oral cavityand, articles published in languages other than English were excluded. The relevant information was summarized.
There were initially 64 results for the above parameters; 47 studies were excluded, leaving 17 studies for analysis. Characteristics of the included studies, PS, and PDT protocol were summarized.
The outcome of the included studies suggested that ALA-PDT is an effective, easy to perform technique, well tolerated treatment with encouraging achievements in the treatment of oral premalignant lesions. No systemic side effects and skin photosensitivity were reported with topical ALA even within initial 48 hours after PDT, and patients were not required to avoid exposure to light following treatment. The clinical outcome of the ALA-PDT application, as reported in the studies, was also very promising, with either diminution in the size of the lesion or complete remission or improvement in signs and symptoms as well as reduced recurrence.
氨基酮戊酸（ALA）介导的光动力疗法（PDT）被认为是治疗口腔癌前病变的有效治疗选择。ALA 是一种美国食品和药物管理局（FDA）批准的第二代光敏剂（PS），可口服和局部使用。
本系统评价旨在评估 ALA-PDT 治疗口腔癌前病变的疗效。
聚焦问题是，“ALA-PDT 治疗口腔癌前病变是否有效？”在 PubMed/Medline 和 GoogleScholar 中进行了文献检索，使用了以下关键词的不同组合：光动力疗法、口腔癌前病变、口腔白斑（OL）、红斑、口腔红斑白班（OEL）、口腔疣状增生（OVH）和口腔扁平苔藓（OLP）。排除了综述文章、临床前研究、病例报告、评论、给编辑的信、未发表的文章、光动力疗法在口腔以外区域使用的研究以及非英语语言发表的文章。总结了相关信息。
根据上述参数最初有 64 个结果；排除了 47 项研究，留下 17 项研究进行分析。总结了纳入研究的特点、PS 和 PDT 方案。
纳入研究的结果表明，ALA-PDT 是一种有效、易于操作、耐受性良好的治疗方法，在治疗口腔癌前病变方面取得了令人鼓舞的成果。即使在 PDT 后 48 小时内，局部应用 ALA 也没有报告全身副作用和皮肤光敏性，并且患者在治疗后无需避免暴露在光线下。正如研究报告的那样，ALA-PDT 应用的临床结果也非常有前景，病变的大小缩小或完全消退或改善体征和症状以及减少复发。
