Xu Jing, Li Hongxin
Department of Dermatology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China.
Front Pediatr. 2025 Jan 14;12:1501401. doi: 10.3389/fped.2024.1501401. eCollection 2024.
The purpose of this study is to explore the efficacy and safety of hematoporphyrin monomethyl ether mediated photodynamic therapy (HMME-PDT) in treating children with port-wine stains (PWS).
Literature related to the topic was searched in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, and China Science Technology Journal Database online databases. The quality of the literature was evaluated using the Effective Public Health Practice Project. The I statistic was used to evaluate the consistency of the results.
A total of 19 papers were included. Meta-analysis showed that more than half of the children (56.3%) achieved efficacy I (improvement ≥ 60%). 17% of children achieved efficacy II (improvement ≥ 75%). Regardless of whether the outcome variable was efficacy I or efficacy II, the therapeutic efficacy in children with PWS aged 0-3 years was superior to those aged 3-6 and 6-18 years, and children who underwent a treatment course of ≥3 sessions showed better outcomes compared to those who have only 1 or 2 sessions. After treatment with HMME-PDT, better efficacy was seen in the PWS of the face and neck and pink/red PWS. Additionally, almost all children with PWS treated with HMME-PDT developed edema (99.9%), more than half presented purpura (67.6%), some developed crust (30.8%) and hyperpigmentation (15.0%), and a few occurred scar (2.4%) and hypopigmentation (1.4%).
After HMME-PDT treatment, more than half of the pediatric patients showed an improvement of ≥60%, and no serious adverse reaction events occurred. This study demonstrated that HMME-PDT possessed promising therapeutic efficacy in children with PWS, suggesting that HMME-PDT could be considered a recommended treatment strategy for pediatric PWS. However, future development of standardized assessment guidelines and comparative studies are needed to validate the aforementioned conclusions.
https://www.crd.york.ac.uk/prospero/#loginpage, PROSPERO (CRD42024592367).
本研究旨在探讨血卟啉单甲醚介导的光动力疗法（HMME-PDT）治疗儿童葡萄酒色斑（PWS）的疗效和安全性。
在PubMed、Embase、Cochrane图书馆、Web of Science、中国知网、万方和中国科技期刊数据库等在线数据库中检索与该主题相关的文献。采用有效公共卫生实践项目对文献质量进行评估。使用I统计量评估结果的一致性。
共纳入19篇论文。荟萃分析显示，超过半数的儿童（56.3%）达到疗效I（改善≥60%）。17%的儿童达到疗效II（改善≥75%）。无论结局变量是疗效I还是疗效II，0至3岁PWS患儿的治疗效果均优于3至6岁和6至18岁患儿，且接受≥3个疗程治疗的患儿比仅接受1或2个疗程治疗的患儿效果更好。HMME-PDT治疗后，面部和颈部的PWS以及粉红色/红色PWS疗效更佳。此外，几乎所有接受HMME-PDT治疗的PWS患儿均出现水肿（99.9%），超过半数出现紫癜（67.6%），部分出现结痂（30.8%）和色素沉着（15.0%），少数出现瘢痕（2.4%）和色素减退（1.4%）。
HMME-PDT治疗后，超过半数的儿科患者改善≥60%，且未发生严重不良反应事件。本研究表明，HMME-PDT对儿童PWS具有良好的治疗效果，提示HMME-PDT可被视为儿童PWS的推荐治疗策略。然而，未来需要制定标准化评估指南并开展对比研究以验证上述结论。
https://www.crd.york.ac.uk/prospero/#loginpage，PROSPERO（CRD42024592367）
