Morton C A, Whitehurst C, Moseley H, McColl J H, Moore J V, Mackie R M
University Department of Dermatology, Western Infirmary, Glasgow, U.K.
Br J Dermatol. 1996 Nov;135(5):766-71.
The efficacy and suitability of photodynamic therapy (PDT) was compared with that of cryotherapy in the treatment of 40 lesions of Bowen's disease. Lesions were randomized to receive either cryotherapy with liquid nitrogen, or PDT using a portable desktop lamp incorporating a 300 W xenon short arc discharge source. A porphyrin precursor, 5-aminolaevulinic acid (5-ALA), was applied topically 4 h before irradiation in the PDT group. Each lesion received 125 J/cm2 at a fluence rate of 70 mW/cm2. All patients were reviewed at 2-monthly intervals and treatments repeated if required. Cryotherapy produced clearance in 10 of 20 lesions after one treatment, the remaining 10 lesions requiring two or three treatment applications. PDT resulted in clearance of 15 of 20 lesions after one treatment and of the remaining five lesions after a second treatment. The probability that a lesion cleared after one treatment was greater with PDT than cryotherapy (P < 0.01). Cryotherapy was associated with ulceration (five of 20), infection (two of 20) and recurrent disease (two of 20); no such complications occurred following PDT. PDT using a non-laser light source and topical 5-ALA appears to be at least as effective as cryotherapy in the treatment of Bowen's disease with fewer adverse effects.
对40例鲍温病损害采用光动力疗法（PDT）和冷冻疗法进行治疗，并比较二者的疗效和适用性。将损害随机分为两组，分别接受液氮冷冻疗法，或采用含300W氙短弧放电光源的便携式台式灯进行的光动力疗法。在光动力疗法组中，在照射前4小时局部应用卟啉前体5-氨基乙酰丙酸（5-ALA）。每个损害以70mW/cm²的光通量率接受125J/cm²的照射。所有患者每2个月复查一次，必要时重复治疗。冷冻疗法一次治疗后20个损害中有10个清除，其余10个损害需要进行两到三次治疗。光动力疗法一次治疗后20个损害中有15个清除，第二次治疗后其余5个损害清除。光动力疗法一次治疗后损害清除的概率高于冷冻疗法（P<0.01）。冷冻疗法伴有溃疡（20个中有5个）、感染（20个中有2个）和疾病复发（20个中有2个）；光动力疗法后未发生此类并发症。采用非激光光源和局部应用5-ALA的光动力疗法在治疗鲍温病方面似乎至少与冷冻疗法一样有效，且不良反应较少。
