The effect of retinoids on premalignant oral lesions

Abstract

BACKGROUND Retinoids have been studied as chemopreventive treatment for patients with oropharyngeal carcinoma. Vitamin A modulates growth and differentiation of cells, and its deficiency enhances susceptibility to carcinogenesis. The chemopreventive mechanism of action of vitamin A is discussed, and a review of clinical results and side effects of the systemic use of vitamin A is included. The objective of the current report was to review the possible role of topical vitamin A and vitamin A derivatives in the management of patients with oral lesions with a risk of transformation to carcinoma. METHODS: A Medline search was conducted and references identified within the identified papers were also reviewed. RESULTS Only four studies using topical vitamin A for patients with oral leukoplakia have been reported. A complete response was achieved in 10–27% of patients, and a partial response was achieved in 54–90% of patients; however, recurrence of leukoplakia was reported after withdrawing the medication in approximately 50% of patients. The side effects of the topical use were minimal. CONCLUSIONS Although the direct application of higher concentrations of retinoic acid results in suppression of oral leukoplakias only, its use in the treatment of patients with recurrent and persistent lesions may be justified for controlling lesions that otherwise may progress. Further controlled clinical studies are needed. Cancer 2002;95:1258–64. © 2002 American Cancer Society. DOI 10.1002/cncr.10874

A Randomized Double-Blind Placebo-Controlled Phase IIB Trial of Curcumin in Oral Leukoplakia

“…The reported clinical response of previous oral leukoplakia chemoprevention trials ranges from 4% to 67% (25). Vitamin A or retinoid has been the most investigated chemopreventive agent for oral leukoplakia, with a reported response rate of 45% to 67% (26)(27)(28). In the present study, we observed 67.5% clinical response rate (complete or partial) and 20.7% SD after 6 months of intervention.…”

Oral lichen planus (OLP), oral lichenoid lesions (OLL), oral dysplasia, and oral cancer: retrospective analysis of clinicopathological data from 2002–2011

“…Indeed, we found a significant reduction in the severity of dysplasia after local treatment with tretinoin in different concentrations (Retinoral®0.005-0.02 %). This is in accordance with other publications that suggest that topical vitamin A may be a possible treatment for mildly dysplastic OLP because of its reported usefulness in inflammatory OLP and its potential impact on mild oral dysplasia [24][25][26]. Further prospective studies are necessary to assess the potential value of retinoids in treating dysplasia.…”

Postoperative Recurrence as an Associated Factor of Malignant Transformation of Oral Dysplastic Leukoplakia

“…Topical agents (bleomycin or vitamin A) or systemic oral medications (vitamin A or ␤ -carotene) may be effective in healing OL but do not seem to prevent relapses and malignant change [3,4] . Several studies have shown that the surgical management of OL could reduce the risk of developing carcinoma [5,6] .…”