5-aminolevulinic acid photodynamic therapy for the treatment of basal and squamous cell carcinoma: A systematic review

IF 3.1 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-05-24 DOI:10.1016/j.pdpdt.2025.104649

Nathalie C. Zeitouni , Todd Schlesinger , Meenal Kheterpal , Puneet S. Jolly , Jared Jagdeo

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引用次数: 0

Abstract

Background

5-aminolevulinic acid photodynamic therapy (ALA-PDT) is used off-label in the US to treat basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and Bowen disease (BD). We performed a systematic review to assess the efficacy and safety of published ALA-PDT protocols for these conditions.

Methods

A PubMed search was conducted through August 8, 2024, to identify studies evaluating 10 % or 20 % ALA-PDT in BCC, SCC, and BD. Randomized controlled trials, observational studies, and case series with >5 patients were included. Quality assessment was performed using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results

Fifty-eight studies were included in the analysis (BCC, n = 40; SCC; n = 9, BD, n = 27). Considerable heterogeneity was observed in ALA concentration, light sources, incubation times, and pretreatment strategies, precluding a standardized synthesis of outcomes. ALA-PDT achieved high clearance rates for superficial BCC and BD, with superior cosmetic outcomes compared to surgery or cryosurgery. Studies of ALA-PDT for SCC were limited with short follow-up times. Nodular BCC and SCC lesions demonstrated lower response rates, particularly with ALA-PDT monotherapy. Recurrence rates varied widely and were highest in patients with SCC. The most frequent adverse events were erythema, pain, and scaling.

Conclusions

This review provides a comprehensive summary of evidence-based ALA-PDT protocols for BCC, BD, and SCC, but published protocols are heterogeneous without a clear consensus. While ALA-PDT is effective, safe, and cosmetically favorable for less invasive tumors, protocol variability underscores the need for further randomized controlled trials to determine optimal treatment parameters.

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5-氨基乙酰丙酸光动力疗法治疗基底细胞癌和鳞状细胞癌：系统综述。

背景：5-氨基乙酰丙酸光动力疗法（ALA-PDT）在美国被用于治疗基底细胞癌（BCC）、鳞状细胞癌（SCC）和鲍恩病（BD）。我们进行了一项系统综述，以评估已发表的ALA-PDT方案对这些疾病的有效性和安全性。方法：通过PubMed检索到2024年8月8日，以确定在BCC， SCC和BD中评估10%或20% ALA-PDT的研究，包括随机对照试验，观察性研究和bbb50患者的病例系列。质量评估采用建议分级评估、发展和评价方法进行。结果：58项研究被纳入分析(BCC, n = 40；SCC, n = 9，BD, n = 27)。在ALA浓度、光源、孵育时间和预处理策略方面观察到相当大的异质性，因此无法对结果进行标准化合成。ALA-PDT对浅表BCC和BD的清除率很高，与手术或冷冻手术相比，具有更好的美容效果。ALA-PDT治疗SCC的研究有限，随访时间短。结节性BCC和SCC病变反应率较低，特别是ALA-PDT单药治疗。复发率差异很大，在SCC患者中复发率最高。最常见的不良事件是红斑、疼痛和脱屑。结论：本综述全面总结了以证据为基础的ALA-PDT治疗BCC、BD和SCC的方案，但已发表的方案各不相同，没有明确的共识。虽然ALA-PDT对侵袭性较小的肿瘤有效、安全、美观，但方案的可变性强调需要进一步的随机对照试验来确定最佳治疗参数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.