Photodynamic therapy for oral potentially malignant disorders

Area of Science:

• Oncology
• Dermatology
• Photomedicine

Background:

• Oral potentially malignant disorders (OPMDs) represent a significant risk for oral cancer development.
• Current treatment modalities for OPMDs have limitations, necessitating exploration of alternative therapies.
• Photodynamic therapy (PDT) has emerged as a promising minimally invasive treatment option.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of photodynamic therapy (PDT) in managing oral potentially malignant disorders (OPMDs).
• To assess the impact of various PDT parameters, including photosensitizers and application methods, on treatment outcomes.
• To identify factors influencing the effectiveness of PDT for OPMDs.

Main Methods:

• A systematic review and meta-analysis of studies published in PubMed and Embase up to December 2018.
• Inclusion of studies assessing the curative effect of PDT for OPMDs.
• Application of random or fixed effects models for pooled estimate calculations.

Main Results:

• PDT resulted in a pooled lesion size reduction of 1.38 cm² (95% CI: 0.39-2.36).
• Overall complete response (CR) was 0.52 (95% CI: 0.36-0.68) and partial response (PR) was 0.82 (95% CI: 0.74-0.88).
• 20% aminolevulinic acid showed higher efficacy (CR: 0.68) than other photosensitizers, and topical application was superior to gargling methylene blue.

Conclusions:

• Photodynamic therapy (PDT) is an effective treatment for OPMDs, leading to significant lesion size reduction and response rates.
• Treatment outcomes are influenced by factors such as photosensitizer type (e.g., 20% aminolevulinic acid) and administration route (topical vs. gargling).
• Oral lichen planus showed a comparatively poorer response to PDT.