Switching From Conventional Photodynamic Therapy to Daylight Photodynamic Therapy For Actinic Keratoses: Systematic Review and Meta-analysis

Actas Dermosifiliogr. 2017 May;108(4):282-292. doi: 10.1016/j.ad.2016.09.020. Epub 2017 Jan 4.
[Article in English, Spanish]

Abstract

Actinic keratosis is a precursor lesion to the most common nonmelanoma skin cancer. Conventional photodynamic therapy (PDT) has been shown to be effective, but the procedure is time-consuming, can be very painful, and requires infrastructure. These shortcomings led to the emergence of daylight PDT. To obtain a global estimate of efficacy, we undertook a systematic literature review and performed a meta-analysis of the available evidence on the efficacy and safety of daylight PDT as compared to conventional PDT in the treatment of actinic keratosis and/or field cancerization. The conclusion is that the difference in efficacy is clinically negligible (global estimate of the mean response rate difference, -3.69%; 95% CI, -6.54% to -0.84%). The adverse effects of daylight PDT are mild and localized (79% of patients report no discomfort), and patients report less pain (P<.001). Daylight PDT gives good to excellent cosmetic results in more than 90% of patients, and patient satisfaction is greater (P<.001).

Keywords: Actinic keratosis; Daylight photodynamic therapy; Photodynamic therapy; Queratosis actínicas; Terapia fotodinámica; Terapia fotodinámica con luz de día; Tratamiento; Treatment.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Carcinoma, Squamous Cell / prevention & control
  • Clinical Trials, Phase III as Topic
  • Esthetics
  • Humans
  • Keratosis, Actinic / drug therapy*
  • Neoplasms, Radiation-Induced / prevention & control
  • Oxidation-Reduction
  • Pain / etiology
  • Patient Satisfaction
  • Photochemistry
  • Photochemotherapy / adverse effects
  • Photochemotherapy / methods*
  • Photosensitizing Agents / therapeutic use
  • Randomized Controlled Trials as Topic
  • Sunlight* / adverse effects
  • Ultraviolet Rays / adverse effects

Substances

  • Photosensitizing Agents