Photodynamic therapy in the treatment of oral leukoplakia: A systematic review

Photodiagnosis Photodyn Ther. 2019 Mar:25:17-22. doi: 10.1016/j.pdpdt.2018.10.023. Epub 2018 Nov 1.

Abstract

Objective: The aim of the present study was to systematically review the efficacy of photodynamic therapy (PDT) in the management of oral leukoplakia (OLK).

Methods: This systematic review aimed to address the following focused question: "Is photodynamic therapy effective in the management of oral leukoplakia?'' PubMed/Medline, EMBASE, ISI Web of Knowledge, OVID, CNKI, and WANFANG DATA were searched up to and including June 2018 using different combinations of the following keywords: photodynamic therapy, leukoplakia, oral dysplasia, oral precancers, and oral premalignant lesions.

Results: Sixteen studies were included in the present study. A total of 352 patients was included in this review, with age ranging from 20 to 79 years. Photosensitizers used were aminolevulinic acid, Photofrin, methylene blue, and chlorine-e6. Laser wavelength, duration of irradiation, and power density were 420-660 nm, 60-1000 s, and 100-150 mW/cm2, respectively. On the whole, the rates of complete response and partial response were 32.9% and 43.2%, and the sum was 76.1%. The follow-up period ranged from 1 month to 119 months. The recurrence rate of OLK was 0-60%.

Conclusion: PDT appears to be a useful therapeutic strategy in the management of oral leukoplakia as a non-surgical treatment. Further RCTs with long follow-up period, standardized PDT parameters, and comparing efficacy of PDT with various other therapies are needed to acquire definite conclusions.

Keywords: Light source; Oral dysplasia; Oral leukoplakia; Oral premalignant lesions; Photodynamic therapy; Photosensitizer.

Publication types

  • Systematic Review

MeSH terms

  • Humans
  • Leukoplakia, Oral / drug therapy*
  • Photochemotherapy / adverse effects
  • Photochemotherapy / methods*
  • Photosensitizing Agents / adverse effects
  • Photosensitizing Agents / therapeutic use*
  • Precancerous Conditions

Substances

  • Photosensitizing Agents