5-aminolevulinic acid 光动力疗法对奥尔森 3 级光化性角化病的疗效：前瞻性队列研究

IF 3.1 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-03-13 DOI:10.1016/j.pdpdt.2025.104555

Qinyuan Zhu , Jing Luan , Ying Tang , Wenjuan Ma , Wenyu Wu , Shujun Chen

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引用次数: 0

摘要

背景：光化性角化病（AK）是一种常见的皮肤角化细胞发育不良，按Olsen分级（OG） 1-3分类。OG 3 AK具有较高的进展为皮肤鳞状细胞癌（cSCC）的风险，提出了治疗挑战。虽然5-氨基乙酰丙酸光动力疗法（ALA-PDT）对非角化过度AK （OG 1-2）有效，但其对OG 3 AK的疗效仍存在争议。方法：为了评估ALA-PDT治疗OG - 3型AK的疗效和安全性，本单中心前瞻性队列研究纳入了127例组织病理学证实的AK患者，按Olsen分级(OG - 3, n=33；OG 1或2，n=94)。所有患者均接受4次ALA-PDT治疗，随访12个月。主要终点是3个月时的初始完全清除（CC），而12个月时的持续CC是次要终点。在整个研究过程中对安全性进行了评估。结果：OG 1/2组初始CC率为92.55% (87/94)，OG 3组为87.88%（29/33）。OG 3组和OG 1/2组12个月的持续CC率分别为89.66%（26/29）和86.21%（75/87）。两组的初始CC率和持续CC率均无显著差异（p < 0.05）。不良事件大多是轻微和短暂的，尽管与OG 1/2组相比，OG 3组在12个月时长期红斑更为常见（23.08%比5.33%,p=0.01）。结论：ALA-PDT对OG 3 AK具有良好的疗效和安全性，支持ALA-PDT作为OG 3 AK有价值的无创治疗选择。

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Efficacy of 5-aminolevulinic acid photodynamic therapy for Olsen Grade 3 actinic keratosis: A prospective cohort study

Background

Actinic keratosis (AK) is a common cutaneous keratinocyte dysplasia categorized by the Olsen Grade (OG) 1–3. OG 3 AK, which has a higher risk of progressing to cutaneous squamous cell carcinoma (cSCC), presents treatment challenges. While 5-aminolevulinic acid photodynamic therapy (ALA-PDT) is effective for non-hyperkeratotic AK (OG 1–2), its efficacy for OG 3 AK remains debated.

Methods

To evaluate the efficacy and safety of ALA-PDT for the treatment of OG 3 AK, this single-center prospective cohort study included 127 patients with histopathologically confirmed AK, grouped by the Olsen grading (OG 3, n = 33; OG 1 or 2, n = 94). All patients received four sessions of ALA-PDT and were followed up for 12 months. The primary outcome was initial complete clearance (CC) at 3 months, while sustained CC at 12 months was the secondary outcome. Safety was assessed throughout the study.

Results

The initial CC rates were 87.88 % (29/33) for the OG 3 group and 92.55 % (87/94) for the OG 1/2 group. The sustained CC rates at 12 months were 89.66 % (26/29) and 86.21 % (75/87) for the OG 3 and OG 1/2 groups, respectively. No significant difference was observed between the two groups for either initial CC or sustained CC rates (p > 0.05). Adverse events were mostly mild and transient, though long-lasting erythema at 12 months was more common in the OG 3 group compared with the OG 1/2 group (23.08 % vs. 5.33 %, p = 0.01).

Conclusion

ALA-PDT demonstrates favorable efficacy and safety profile for OG 3 AK, supporting ALA-PDT as a valuable non-invasive treatment option for OG 3 AK.

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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.