癌症患者口腔黏膜炎的光动力疗法——一项系统评价与荟萃分析
Photodynamic therapy for oral mucositis in cancer patients- a systematic review and meta-analysis.
作者信息
Joseph Betsy, Mauramo Matti, Vijayakumary Baiju Kamalasanan, Waltimo Tuomas, Anil Sukumaran, Sorsa Timo
机构信息
Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland; Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
出版信息
Photodiagnosis Photodyn Ther. 2024 Dec;50:104424. doi: 10.1016/j.pdpdt.2024.104424. Epub 2024 Nov 28.
AIM
This systematic review aimed to evaluate the efficacy of photodynamic therapy (PDT) in reducing the severity of chemotherapy-induced oral mucositis, and associated symptoms in cancer patients compared to standard care or other interventions.
MATERIALS AND METHODS
A comprehensive literature search identified seven relevant studies (randomized controlled trials and non-randomized clinical trials) published between January 1, 2000, and May 31, 2024. The data analysis was carried out using the standardized mean difference as the outcome measure. A random-effects model was fitted to the data. The rank correlation test and the regression test, using the standard error of the observed outcomes as predictors, were used to check for funnel plot asymmetry.
RESULTS
Studies combining PDT with photobiomodulation therapy (PBMT) consistently showed superior therapeutic outcomes compared to PBMT alone, particularly in accelerating healing and reducing pain. In the meta-analysis (k = 4), the observed standardized mean differences ranged from -0.9605 to -0.0223, with most estimates being negative (100 %). The estimated average standardized mean difference based on the random-effects model was -0.5138 (95% CI: -0.8799 to -0.1477).
CONCLUSION
PDT, especially when combined with PBMT, shows promise in reducing the severity of oral mucositis and associated symptoms in cancer patients.
目的
本系统评价旨在评估光动力疗法（PDT）与标准护理或其他干预措施相比，在减轻癌症患者化疗引起的口腔黏膜炎严重程度及相关症状方面的疗效。
材料与方法
全面的文献检索确定了2000年1月1日至2024年5月31日期间发表的7项相关研究（随机对照试验和非随机临床试验）。数据分析采用标准化均值差作为结局指标。对数据拟合随机效应模型。使用观察到的结局的标准误差作为预测因子的秩相关检验和回归检验，用于检查漏斗图的不对称性。
结果
与单独使用光生物调节疗法（PBMT）相比，将PDT与PBMT联合使用的研究始终显示出更好的治疗效果，尤其是在加速愈合和减轻疼痛方面。在荟萃分析（k = 4）中，观察到的标准化均值差范围为-0.9605至-0.0223，大多数估计值为负数（100%）。基于随机效应模型估计的平均标准化均值差为-0.5138（95% CI：-0.8799至-0.1477）。
结论
PDT，尤其是与PBMT联合使用时，在减轻癌症患者口腔黏膜炎的严重程度及相关症状方面显示出前景。
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