Photodynamic Therapy – A Non-invasive Treatment Modality for Precancerous Lesions

Abstract

Introduction: Oral premalignant lesions are conditions having high potential tendency for transformation into malignancy. The use of a conservative and effective treatment modality is one of the best strategies for cancer prevention. Photodynamic therapy (PDT) is a noninvasive method for topical and selective treatment of oral precancerous lesions. The present study was taken up to determine the efficacy of PDT in oral precancerous lesions. Methods: The study consisted 13 patients with 24 oral leukoplakia (OL) lesions and 8 with 20 oral lichen planus (OLP) lesions, divided into control and study groups. These lesions were affecting various intraoral sites, the buccal mucosa being the most common site followed by tongue and gingiva. The treatment regimen of PDT included 98% 5-aminolevulinic acid (5-ALA) which is topical applied and irradiated with light emitting diode (LED) of 420 nm wavelengths at several sessions. Results: In OL 16.6% of cases showed complete response, 66.6% partial response and 16.6% no response of the lesions to the treatment. In OLP 80% and 20% of the lesions showed partial and no response respectively. The differences with control groups for OL + OLP were found to be significant (P < 0.001). Conclusion: Based on the results of the present study, we can conclude that PDT appears to be a feasible alternative to conventional therapy for oral premalignant lesions.

Efficacy of photodynamic therapy in the treatment of symptomatic oral lichen planus: A systematic review

“…After full‐text evaluation, 7 studies were excluded based on the inclusion and exclusion criteria. The remaining 5 studies were included in the systematic review and processed for data extraction.…”

“…Five studies were included in this review, 3 of which were RCTs and 2 were non‐RCT . In all studies, the efficacy of PDT was compared with topical corticosteroids (Table ).…”

“…In all studies, the efficacy of PDT was compared with topical corticosteroids (Table ). Two studies were conducted in Egypt, 2 in Iran, and 1 in India . In all studies, diagnosis of OLP was based on clinical and histopathological features.…”

“…In the presence of tissue oxygen, the interaction will produce cytotoxic oxygen free radicals that are suggested to be responsible for the therapeutic action of PDT . Many studies have evaluated the efficacy of PDT in management of OLP . Mostafa et al reported better improvement in signs and symptoms of OLP among PDT‐treated group compared to corticosteroid group.…”

“…Mostafa et al reported better improvement in signs and symptoms of OLP among PDT‐treated group compared to corticosteroid group. Additionally, Bakhitari et al and Maloth reported that PDT was as effective as topical corticosteroid in the management of OLP. However, Jajarm et al, reported that topical dexamethasone showed significantly better improvement in symptoms and amount of relapse than PDT.…”