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Peralta-Mamani M, Silva BMDA, Honório HM, Rubira-Bullen IRF, Hanna R, Silva PSSDA. CLINICAL EFFICACY OF PHOTODYNAMIC THERAPY IN MANAGEMENT OF ORAL POTENTIALLY MALIGNANT DISORDERS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2024; 24:101899. [PMID: 38821659 DOI: 10.1016/j.jebdp.2023.101899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 06/02/2024]
Abstract
OBJECTIVES Despite phototherapy (in the form of photodynamic therapy (PDT)-mediated oxidative stress) being utilized in the management of oral potentially malignant disorders (OPMDs), the evidence of certainty remains unclear. Hence, this systematic review and meta-analysis (PROSPERO # CRD42021218748) is aimed to evaluate the clinical efficacy of PDT-induced oxidative stress in OPMDs METHODS: PubMed, Embase, Web of Science, Scopus, and Cochrane Library databases were searched without restriction of language or year of publication. In addition, gray literature was searched and a manual search was performed. Two independent reviewers screened all the studies, assessing data extraction, risk of bias and certainty of evidence. A narrative synthesis was carried out. For the meta-analysis, random effects were considered to determine the prevalence of a total and a partial remission (PR) of oral potentially malignant disorders (OPMDs). The certainty of evidence was explored using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS Twenty-three studies were included in the qualitative and quantitative syntheses. A total of 880 patients were included (564 males; 218 females) with an age range between 24 and 89-years-old. The results showed the prevalence of the total and partial remissions respectively for the following OPMLs: actinic cheilitis (AC): 69.9% and 2.4%; oral leukoplakia (OL): 44% and 36.9%; oral verrucous hyperplasia (OVH): 98.5%; oral erythroleukoplakia (OEL): 92.1% and 7.9%. The prevalence of no remission of OL was 18.8%. CONCLUSIONS PDT demonstrated significant results in clinical remission of OPMDs and most of the eligible studies have shown a total or a partial remission of the included lesions, but at a low or a very low certainty of evidence. Hence, further clinical studies with robust methodology are warranted to offer further validated data. Also, further evidence is required to understand further the mechanism of PDT-induced oxidative stress.
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Affiliation(s)
- Mariela Peralta-Mamani
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | - Bruna Machado DA Silva
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | | | - Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy; Department of Restorative Dental Sciences, UCL-Eastman Dental Institute, Faculty of Medical Sciences, London, UK; Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London UK.
| | - Paulo Sergio Santos DA Silva
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
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Guo J, Chen X, Xie H, Li T. Efficacy of adjunctive photodynamic therapy to conventional mechanical debridement for peri-implant mucositis. BMC Oral Health 2024; 24:464. [PMID: 38627721 PMCID: PMC11020816 DOI: 10.1186/s12903-024-04198-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE This meta-analysis was conducted to assess the effectiveness of photodynamic therapy (PDT) as an adjunct to conventional mechanical debridement (CMD) for the management of peri-implant mucositis (p-iM). METHODS We systematically searched four databases (PubMed, Embase, Web of Science, and Cochrane Library) for randomized controlled trials (RCTs) investigating PDT + CMD for p-iM from their inception to March 13, 2023. Meta-analysis was performed using RevMan 5.4 software. RESULTS Seven RCTs met the inclusion criteria. The meta-analysis revealed that PDT + CMD treatment was more effective than CMD alone in reducing probing depth (PD) (Mean Difference [MD]: -1.09, 95% Confidence Interval [CI]: -1.99 to -0.2, P = 0.02) and plaque index (PI) (MD: -2.06, 95% CI: -2.81 to -1.31, P < 0.00001). However, there was no statistically significant difference in the improvement of bleeding on probing (BOP) between the PDT + CMD groups and CMD groups (MD: -0.97, 95% CI: -2.81 to 0.88, P = 0.31). CONCLUSIONS Based on the current available evidence, this meta-analysis indicates that the addition of PDT to CMD significantly improves PD and PI compared to CMD alone in the treatment of p-iM. However, there is no significant difference in improving BOP.
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Affiliation(s)
- Jincai Guo
- Changsha Stomatological Hospital, No. 389 Youyi road, Tianxin district Changsha, Changsha, Hunan, 410006, China
- School of Stomatology, Hunan University of Chinese Medicine, Changsha, 410006, China
| | - Xueru Chen
- Changsha Stomatological Hospital, No. 389 Youyi road, Tianxin district Changsha, Changsha, Hunan, 410006, China
- School of Stomatology, Hunan University of Chinese Medicine, Changsha, 410006, China
| | - Hui Xie
- Changsha Stomatological Hospital, No. 389 Youyi road, Tianxin district Changsha, Changsha, Hunan, 410006, China.
- School of Stomatology, Hunan University of Chinese Medicine, Changsha, 410006, China.
| | - Tongjun Li
- Changsha Stomatological Hospital, No. 389 Youyi road, Tianxin district Changsha, Changsha, Hunan, 410006, China.
- School of Stomatology, Hunan University of Chinese Medicine, Changsha, 410006, China.
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Domka W, Bartusik-Aebisher D, Mytych W, Myśliwiec A, Dynarowicz K, Cieślar G, Kawczyk-Krupka A, Aebisher D. Photodynamic Therapy for Eye, Ear, Laryngeal Area, and Nasal and Oral Cavity Diseases: A Review. Cancers (Basel) 2024; 16:645. [PMID: 38339396 PMCID: PMC10854993 DOI: 10.3390/cancers16030645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/23/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Photodynamic therapy (PDT) has emerged as a promising modality for the treatment of various diseases. This non-invasive approach utilizes photosensitizing agents and light to selectively target and destroy abnormal cells, providing a valuable alternative to traditional treatments. Research studies have explored the application of PDT in different areas of the head. Research is focusing on a growing number of new developments and treatments for cancer. One of these methods is PDT. Photodynamic therapy is now a revolutionary, progressive method of cancer therapy. A very important feature of PDT is that cells cannot become immune to singlet oxygen. With this therapy, patients can avoid lengthy and costly surgeries. PDT therapy is referred to as a safe and highly selective therapy. These studies collectively highlight the potential of PDT as a valuable therapeutic option in treating the head area. As research in this field progresses, PDT may become increasingly integrated into the clinical management of these conditions, offering a balance between effectiveness and minimal invasiveness.
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Affiliation(s)
- Wojciech Domka
- Department of Otolaryngology, Medical College of The University of Rzeszów, 35-959 Rzeszów, Poland;
| | - Dorota Bartusik-Aebisher
- Department of Biochemistry and General Chemistry, Medical College of the University of Rzeszów, 35-959 Rzeszów, Poland;
| | - Wiktoria Mytych
- Students English Division Science Club, Medical College of The University of Rzeszów, 35-959 Rzeszów, Poland;
| | - Angelika Myśliwiec
- Center for Innovative Research in Medical and Natural Sciences, Medical College of The University of Rzeszów, 35-310 Rzeszów, Poland; (A.M.); (K.D.)
| | - Klaudia Dynarowicz
- Center for Innovative Research in Medical and Natural Sciences, Medical College of The University of Rzeszów, 35-310 Rzeszów, Poland; (A.M.); (K.D.)
| | - Grzegorz Cieślar
- Department of Internal Diseases, Angiology and Physical Medicine, Centre for Laser Diagnostics and Therapy, Medical University of Silesia, Batorego 15, 41-902 Bytom, Poland;
| | - Aleksandra Kawczyk-Krupka
- Department of Internal Diseases, Angiology and Physical Medicine, Centre for Laser Diagnostics and Therapy, Medical University of Silesia, Batorego 15, 41-902 Bytom, Poland;
| | - David Aebisher
- Department of Photomedicine and Physical Chemistry, Medical College of the University of Rzeszów, 35-959 Rzeszów, Poland
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Liu W, Zhang X, Shen X, Liu L. Evaluating photodynamic therapy for oral precancerous lesions: Highlighting outcome measure of malignant transformation. J Dent Sci 2024; 19:631-636. [PMID: 38303828 PMCID: PMC10829732 DOI: 10.1016/j.jds.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/12/2023] [Indexed: 02/03/2024] Open
Abstract
The main outcome measure assessed in previous studies on photodynamic therapy (PDT) for oral precancerous lesions (OPL) is clinical response based on the alteration in lesion size after treatment. However, the primary and secondary outcome measures of the interventions for OPL should be malignant transformation and recurrence. Thus, the objective of this short communication is to summarize the evidence on PDT in preventing the recurrence and malignant transformation of OPL. There were 16 eligible studies which addressed the issue of OPL patients who received PDT with recurrence outcome, and the pooled recurrence rate (95% confidence interval) was analyzed to be 20.1% (16.2-24.6%). Notably, only 1 study reported that 7.5% of malignant transformation rate for OPL received PDT. These should be interpreted with caution due to low-level evidence, such as differences in study design, clinical and pathological features of patients enrolled, limited sample size, short follow-up time. Given few evaluated the effect of PDT on malignant transformation, we highlight that this primary outcome measure of OPL needs to be investigated in further well-designed longitudinal studies with adequate follow-up periods.
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Affiliation(s)
- Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Fengcheng Hospital of Fengxian District, Shanghai Ninth People’s Hospital Fengcheng Branch Hospital, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaochen Zhang
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuemin Shen
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral Mucosal Diseases, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liu Liu
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Zhang R, Gao T, Wang D. Photodynamic therapy (PDT) for oral leukoplakia: a systematic review and meta-analysis of single-arm studies examining efficacy and subgroup analyses. BMC Oral Health 2023; 23:568. [PMID: 37574560 PMCID: PMC10424357 DOI: 10.1186/s12903-023-03294-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/07/2023] [Indexed: 08/15/2023] Open
Abstract
OBJECTIVE This study aims to evaluate the efficacy of photodynamic therapy (PDT) in the treatment of oral leukoplakia and explore the subgroup factors that may influence its effectiveness. METHODS A systematic search was conducted in PubMed, Embase, the Cochrane Library, and Web of Science databases to identify relevant studies. Meta-analysis was performed using Stata15.0 software. Cochran's Q test and I2 statistics were used to evaluate heterogeneity, egger's test was used to evaluate publication bias. RESULTS The analysis of 17 studies included in this study suggests that PDT may be effective in achieving complete response (CR) [ES = 0.50, 95%CI: (0.33,0.66)], partial response (PR) [ES = 0.42, 95%CI: (0.27,0.56)], no response (NR) [ES = 0.19, 95%CI: (0.11,0.27)]in patients with oral leukoplakia. The recurrence rate was also evaluated [ES = 0.13, 95%CI: (0.08,0.18)]. Subgroup analysis showed that various factors such as light source, wavelength, medium, duration of application, clinical and pathological diagnosis classification influenced efficacy of PDT. The lesion areas of the leukoplakia after treatment were reduced by 1.97cm2 compared with those before treatment. CONCLUSION Our findings show that PDT is a viable treatment for oral leukoplakia. However, the effectiveness of the therapy may depend on several factors, as suggested by our subgroup analyses. (Registration no. CRD42023399848 in Prospero, 26/02/2023).
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Affiliation(s)
- Rui Zhang
- Department of General Stomatology, General Hospital of Ningxia Medical University, Yinchuan, 750004, China.
| | - Tong Gao
- Department of Prosthodontics, Affiliated Hospital of Yanan University, Shaanxi, 716000, China
| | - Dan Wang
- Department of Stomatology, Qingtongxia Hospital of Traditional Chinese Medicine, Ningxia, 751600, China
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Mosaddad SA, Namanloo RA, Aghili SS, Maskani P, Alam M, Abbasi K, Nouri F, Tahmasebi E, Yazdanian M, Tebyaniyan H. Photodynamic therapy in oral cancer: a review of clinical studies. Med Oncol 2023; 40:91. [PMID: 36749489 DOI: 10.1007/s12032-023-01949-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/08/2023] [Indexed: 02/08/2023]
Abstract
A significant mortality rate is associated with oral cancer, particularly in cases of late-stage diagnosis. Since the last decades, oral cancer survival rates have only gradually improved despite advances in treatment. This poor success rate is mainly due to the development of secondary tumors, local recurrence, and regional failure. Invasive treatments frequently have a negative impact on the aesthetic and functional outcomes of survivors. Novel approaches are thus needed to manage this deadly disease in light of these statistics. In photodynamic therapy (PDT), a light-sensitive medication called a photosensitizer is given first, followed by exposure to light of the proper wavelength that matches the absorbance band of the photosensitizer. The tissue oxygen-induced cytotoxic free radicals kill tumor cells directly, harm the microvascular structure, and cause inflammatory reactions at the targeted sites. In the case of early lesions, PDT can be used as a stand-alone therapy, and in the case of advanced lesions, it can be used as adjuvant therapy. The current review article discussed the uses of PDT in oral cancer therapy based on recent advances in this field.
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Affiliation(s)
- Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Poorya Maskani
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Nouri
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Elahe Tahmasebi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran.
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Yao Y, Wang Y, Li C, Wu L, Tang G. Management of oral leukoplakia by ablative fractional laser‐assisted photodynamic therapy: A 3‐year retrospective study of 48 patients. Lasers Surg Med 2022; 54:682-687. [PMID: 35253237 PMCID: PMC9314786 DOI: 10.1002/lsm.23534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/29/2022] [Accepted: 02/21/2022] [Indexed: 11/16/2022]
Abstract
Objectives This study aimed to review the results of oral leucoplakia (OL) using ablative fractional laser‐assisted photodynamic therapy (AFL‐PDT) and to further evaluate the risk factors for recurrence and malignant transformation. Materials and Methods Forty‐eight patients diagnosed with OL using histopathology were enrolled in this study. All patients received one session of AFL‐PDT. Therapeutic efficacy was evaluated 1 month posttreatment. Follow‐up was scheduled every 3 months in the first year and every 6 months thereafter. Results An overall positive response rate of 87.5% (42/48) was achieved, including 62.5% (30/48) complete responses and 25.0% (12/48) partial responses. During the 3‐year follow‐up period, the recurrence and malignant transformation rates were 37.5% (18/48) and 8.3% (4/48), respectively. Lesions on gingiva/palate seemed to be associated with recurrence (p < 0.001; odds ratio [OR]: 1.64, 95% confidence interval [CI]: 1.13–2.37). The severity of epithelial dysplasia (p = 0.02; OR: 2.93, 95% CI: 1.96–4.42) and recurrence (p = 0.016; OR: 3.14, 95% CI: 2.04–4.84) were associated with a predisposition to malignant transformation. Conclusions AFL‐PDT is an effective management of OL, but requires close follow‐up. OL lesions on the gingiva/palate are predisposed to recurrence. OLs that recur with moderate/severe epithelial dysplasia have a higher risk of transforming into oral squamous cell carcinoma.
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Affiliation(s)
- Yi‐Lin Yao
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases Shanghai Key Laboratory of Stomatology Shanghai China
| | - Yu‐Feng Wang
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases Shanghai Key Laboratory of Stomatology Shanghai China
| | - Chen‐Xi Li
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases Shanghai Key Laboratory of Stomatology Shanghai China
| | - Lan Wu
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases Shanghai Key Laboratory of Stomatology Shanghai China
| | - Guo‐Yao Tang
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases Shanghai Key Laboratory of Stomatology Shanghai China
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Binnal DA, Tadakamadla DJ, Rajesh DG, Tadakamadla DSK. Photodynamic therapy for oral potentially malignant disorders: A Systematic Review and Meta-analysis. Photodiagnosis Photodyn Ther 2022; 37:102713. [PMID: 34999271 DOI: 10.1016/j.pdpdt.2022.102713] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/29/2021] [Accepted: 01/03/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of Photodynamic Therapy (PDT) in the treatment of Oral Potentially Malignant Disorders (OPMDs) patients. METHODOLOGY An electronic search was conducted to retrieve articles published until September 2021. Meta-analyses were conducted for the outcomes of complete response (CR) and any response (AR) after treatment with PDT using data from single-arm studies, case series and non-randomised controlled trials (NRCTs). RESULTS In total, 49 articles were included. RCTs revealed insignificant mean difference (MD) in efficacy index between PDT and comparison groups (MD: 1.32; 95% CI:-28.10-30.72, p=0.930). The likelihood of CR (OR:0.84; 95% CI: 0.42-1.71, p=0.637) or AR (OR:2.10; 95% CI: 0.31-14.25, p=0.448) was not different in PDT group when compared with any comparison treatments in NRCTs. CR/AR among single arm studies was 60.6% (95% CI: 50.5-70.7, P<0.001) and 93.7% (95% CI:91.5-95.8, P<0.001) respectively. Higher prevalence of CR and AR was observed for dysplasia or carcinoma insitu (CIS) (CR: 81%, 95% CI: 70.8-91.3, P<0.001; AR: 94.3%; 95% CI: 89-99.6, P<0.001) and actinic cheilitis (AC) (CR: 73.9%, 95% CI: 65.9-81.9, P<0.001; AR:97%; 95% CI:94.9-99, P<0.001). CONCLUSIONS More than half of the patients receiving PDT showed CR, with more than 90% responding to the treatment. PDT was most effective on oral dysplasias, followed by AC.
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Affiliation(s)
- Dr Almas Binnal
- Associate Professor, Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Mangalore - 575001, Manipal Academy of Higher Education, Manipal, Karnataka, India-576104.
| | | | - Dr Gururaghavendran Rajesh
- Professor and Head, Department of Public Health Dentistry, Manipal College of Dental Sciences, Mangalore - 575001, Manipal Academy of Higher Education, Manipal, Karnataka, India-576104.
| | - Dr Santosh Kumar Tadakamadla
- Senior Research Fellow, National Health and Medical Research Council Early Career Fellow, School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Australia.
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Romano A, Di Stasio D, Gentile E, Petruzzi M, Serpico R, Lucchese A. The potential role of Photodynamic therapy in oral premalignant and malignant lesions: A systematic review. J Oral Pathol Med 2021; 50:333-344. [PMID: 33217059 DOI: 10.1111/jop.13139] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is considered as a valid treatment option in various branches of dentistry. This systematic review aims to evaluate the usefulness of PDT for treatment of oral premalignant and malignant lesions. METHODS The MeSH terms "Photodynamic therapy" and "PDT," in combination with other terms, have been searched by three search engines (PubMed, ISI Web of Science, and the Cochrane Library), and a systematic review has been performed. The Population, Intervention, Comparison, Outcomes, and Study design (PICOS) has been applied as method to outline our study eligibility criteria. Risk of Bias in Non-randomized Studies of Intervention (ROBINS-I) has been performed too. RESULTS Initial results were 1513. Definitely, 27 studies met our selection criteria. CONCLUSIONS Topical PDT is an easy to perform technique, well-tolerated treatment and it appears to be an effective method with encouraging achievements in the treatment of premalignant and malignant lesions of the soft tissues of the oral cavity; nevertheless more studies are required to integrate the up-to-date experience of this application.
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Affiliation(s)
- Antonio Romano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Dario Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Enrica Gentile
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, University of Bari "A. Moro", Bari, Italy
| | - Rosario Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Photodynamic therapy using topical toluidine blue for the treatment of oral leukoplakia: A prospective case series. Photodiagnosis Photodyn Ther 2020; 31:101888. [PMID: 32593778 DOI: 10.1016/j.pdpdt.2020.101888] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Photodynamic therapy (PDT) is a minimally invasive method for the treatment of oral leukoplakia (OL) through the activation of a photosensitizer, after exposure to a specific wavelength light source. METHODS To investigate the effectiveness of toluidine blue as topical photosensitizer. Eleven patients participated in this study; fifteen oral leukoplakia lesions were treated, in several sessions, with 2.5 % toluidine blue and an LED source of 630 nm wavelength. Patients were evaluated at baseline (t0), at the end of treatment cycles (t1) and one year from the end of treatment (t2). All the treated sites were photographed at each visit. Images were processed with ImageJ 1.52 software in order to obtain the areas (mm2) of the treated lesions. Comparison between data at different follow-up was performed using a paired T-test. RESULTS At t1, complete response was obtained in six lesions, partial response in seven lesions while only two lesions showed no response. At t2, a further improvement was observed in two patients. The analysis of the areas showed significant reduction of the lesion size from t0 to t1 (p = 0.003), and from t1 to t2 (p = 0.01). CONCLUSION Toluidine blue appears to be a promising photosensitizer in the photodynamic therapy of oral leukoplakia.
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Monitoring PDT effects in basal cell carcinoma treatment using thermal imaging. Photodiagnosis Photodyn Ther 2020; 31:101845. [PMID: 32492520 DOI: 10.1016/j.pdpdt.2020.101845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND One of the most frequent type of malignant skin lesion (almost 95 percent of all skin tumours) is basal cell carcinoma (BCC). It is often treated by radiotherapy using ionizing radiation as well by photodynamic therapy (PDT) which is a selective method directed only on cancer cells and well tolerated by patients. MATERIALS AND METHODS Eight male patients of the Department and Clinic of Internal Diseases, Angiology and Physical Medicine in Bytom, Medical University of Silesia, in Katowice, Poland suffering from basal cell carcinoma were monitored by thermovision during the photodynamic therapy. All lesions were diagnosed as superficial were confirmed by histopathological examination. RESULTS The dynamics of changes observed in the isotherm area during the therapy can provide physicians with additional information. The significant increase of observed isotherm area in comparison to the lesion area diagnosed by a physician was confirmed, which may be connected with the increased metabolism processes occurring in the tissue surrounded the lesion. CONCLUSION The obtained results based on the temperature gradient changes in the lesion vicinity area may bring some new information describing the range of biochemical and physiological processes occurring during photodynamic therapy.
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Kawczyk-Krupka A, Bartusik-Aebisher D, Latos W, Cieślar G, Sieroń K, Kwiatek S, Oleś P, Kwiatek B, Aebisher D, Krupka M, Wiench R, Skaba D, Olek M, Kasperski J, Czuba Z, Sieroń A. Clinical Trials and Basic Research in Photodynamic Diagnostics and Therapies from the Center for Laser Diagnostics and Therapy in Poland. Photochem Photobiol 2020; 96:539-549. [PMID: 32112419 DOI: 10.1111/php.13243] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/09/2020] [Indexed: 12/29/2022]
Abstract
The purpose of this review is to present an overview of the development of photodiagnostic and photodynamic therapy (PDD and PDT) techniques in Poland. The paper discusses the principles of PDD, including fluorescent techniques in determining precancerous conditions and cancers of the skin, digestive tract, bladder and respiratory tract. Methods of PDT of cancer will be discussed and the current state of knowledge as well as future trends in the development of photodynamic techniques will be presented, including the possibility of using photodynamic antimicrobial therapy. Research pioneers in photodynamic medicine such as Thomas Dougherty are an inspiration for the development of methods of PDD and PDT in our Clinic. The Center for Laser Diagnostics and Therapy in Bytom, Poland, promotes the propagation of PDD and PDT through the training of clinicians and raising awareness among students in training and the general public. Physicians at the Center are engaged in photomedical research aimed at clinical implementation and exploration of new avenues in photomedicine while optimizing existing modalities. The Center promotes dissemination of clinical results from a wide range of topics in PDD and PDT and serving as representative authorities of photodynamic medicine in Poland and Europe.
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Affiliation(s)
- Aleksandra Kawczyk-Krupka
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | | | - Wojciech Latos
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Grzegorz Cieślar
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Karolina Sieroń
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland.,Department of Physical Medicine, Chair of Physiotherapy, Medical University of Silesia, Katowice, Poland
| | - Sebastian Kwiatek
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Piotr Oleś
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Beata Kwiatek
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - David Aebisher
- Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Magdalena Krupka
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Rafał Wiench
- Department of Periodontal Diseases and Oral Mucosa Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Dariusz Skaba
- Department of Periodontal Diseases and Oral Mucosa Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Marcin Olek
- Department of Prosthetic Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Jacek Kasperski
- Department of Prosthetic Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Zenon Czuba
- Department of Microbiology and Immunology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Aleksander Sieroń
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland.,Department of Physiotherapy, Jan Dlugosz University in Częstochowa, Częstochowa, Poland
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Kim MM, Darafsheh A. Light Sources and Dosimetry Techniques for Photodynamic Therapy. Photochem Photobiol 2020; 96:280-294. [PMID: 32003006 DOI: 10.1111/php.13219] [Citation(s) in RCA: 164] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 11/29/2019] [Indexed: 12/19/2022]
Abstract
Effective treatment delivery in photodynamic therapy (PDT) requires coordination of the light source, the photosensitizer, and the delivery device appropriate to the target tissue. Lasers, light-emitting diodes (LEDs), and lamps are the main types of light sources utilized for PDT applications. The choice of light source depends on the target location, photosensitizer used, and light dose to be delivered. Geometry of minimally accessible areas also plays a role in deciding light applicator type. Typically, optical fiber-based devices are used to deliver the treatment light close to the target. The optical properties of tissue also affect the distribution of the treatment light. Treatment light undergoes scattering and absorption in tissue. Most tissue will scatter light, but highly pigmented areas will absorb light, especially at short wavelengths. This review will summarize the basic physics of light sources, and describe methods for determining the dose delivered to the patient.
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Affiliation(s)
- Michele M Kim
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Arash Darafsheh
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO
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Wang X, Han Y, Jin J, Cheng Z, Wang Q, Guo X, Li W, Liu H. Plum-blossom needle assisted photodynamic therapy for the treatment of oral potentially malignant disorder in the elderly. Photodiagnosis Photodyn Ther 2019; 25:296-299. [DOI: 10.1016/j.pdpdt.2019.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/03/2019] [Accepted: 01/07/2019] [Indexed: 02/08/2023]
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Han Y, Xu S, Jin J, Wang X, Liu X, Hua H, Wang X, Liu H. Primary Clinical Evaluation of Photodynamic Therapy With Oral Leukoplakia in Chinese Patients. Front Physiol 2019; 9:1911. [PMID: 30723421 PMCID: PMC6350274 DOI: 10.3389/fphys.2018.01911] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 12/18/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Photodynamic therapy (PDT) has demonstrated promising results in the treatment of oral leukoplakia. This study evaluated the clinical efficacy and side effects of PDT in the treatment of Chinese patients with oral leukoplakia. Methods: Twenty-nine patients with oral leukoplakia were enrolled in this study, including patients with both homogenous and non-homogenous lesions and various dysplastic tissues. All patients received PDT using a 632 nm laser at 500 mW/cm2 power density at a dosage of 90–180 J/cm2 and with aminolevulinic acid (ALA) used as a photosensitizer. A fixing and restricting complex as well as high laser power density for PDT in oral cavity was applied. Results: An overall response rate of 86.2% was achieved in this study, including 55.2% complete remission and 31.0% partial remission. The only adverse events observed in subjects were transient local ulcer and pain. It is observed the PDT utilizing ALA showed strong effectiveness in patients with moderate to severe dysplasia, as less treatment time per cm2 of lesion is required. Conclusion: Topic ALA-PDT is effective to treat oral leukoplakia, especially for that with the presence of dysplasia. A fixing and restricting complex as well as high laser power density for PDT in oral cavity should be considered as an optimal choice.
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Affiliation(s)
- Ying Han
- Department of Oral Medicine, Peking University School of Stomatology, Beijing, China
| | - Si Xu
- Department of Oral Medicine, Peking University School of Stomatology, Beijing, China
| | - Jianqiu Jin
- National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Xing Wang
- Department of Oral Medicine, Peking University School of Stomatology, Beijing, China
| | - Xiaodan Liu
- Department of Oral Medicine, Peking University School of Stomatology, Beijing, China
| | - Hong Hua
- Department of Oral Medicine, Peking University School of Stomatology, Beijing, China
| | - Xiaoyang Wang
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Hongwei Liu
- Department of Oral Medicine, Peking University School of Stomatology, Beijing, China
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Photodynamic therapy in the treatment of oral leukoplakia: A systematic review. Photodiagnosis Photodyn Ther 2018; 25:17-22. [PMID: 30391342 DOI: 10.1016/j.pdpdt.2018.10.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 09/03/2018] [Accepted: 10/29/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of the present study was to systematically review the efficacy of photodynamic therapy (PDT) in the management of oral leukoplakia (OLK). METHODS This systematic review aimed to address the following focused question: "Is photodynamic therapy effective in the management of oral leukoplakia?'' PubMed/Medline, EMBASE, ISI Web of Knowledge, OVID, CNKI, and WANFANG DATA were searched up to and including June 2018 using different combinations of the following keywords: photodynamic therapy, leukoplakia, oral dysplasia, oral precancers, and oral premalignant lesions. RESULTS Sixteen studies were included in the present study. A total of 352 patients was included in this review, with age ranging from 20 to 79 years. Photosensitizers used were aminolevulinic acid, Photofrin, methylene blue, and chlorine-e6. Laser wavelength, duration of irradiation, and power density were 420-660 nm, 60-1000 s, and 100-150 mW/cm2, respectively. On the whole, the rates of complete response and partial response were 32.9% and 43.2%, and the sum was 76.1%. The follow-up period ranged from 1 month to 119 months. The recurrence rate of OLK was 0-60%. CONCLUSION PDT appears to be a useful therapeutic strategy in the management of oral leukoplakia as a non-surgical treatment. Further RCTs with long follow-up period, standardized PDT parameters, and comparing efficacy of PDT with various other therapies are needed to acquire definite conclusions.
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Lesion oxygenation associates with clinical outcomes in premalignant and early stage head and neck tumors treated on a phase 1 trial of photodynamic therapy. Photodiagnosis Photodyn Ther 2017; 21:28-35. [PMID: 29113960 DOI: 10.1016/j.pdpdt.2017.10.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/06/2017] [Accepted: 10/19/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND We report on a Phase 1 trial of photodynamic therapy (PDT) for superficial head and neck (H&N) lesions. Due to known oxygen dependencies of PDT, translational measurements of lesion hemoglobin oxygen saturation (StO2) and blood volume (tHb) were studied for associations with patient outcomes. METHODS PDT with aminolevulinc acid (ALA) and escalating light doses was evaluated for high-grade dysplasia, carcinoma-in-situ, and microinvasive carcinomas of the H&N. Among 29 evaluable patients, most (18) had lesions of the tongue or floor of mouth (FOM). Disease was intact in 18 patients and present at surgical margins in 11 patients. In 26 patients, lesion StO2 and tHb was measured. RESULTS Local control (LC) at 24 months was 57.5% among all patients. In patients with tongue/FOM lesions LC was 42.7%, and it was 50.1% for those with intact lesions. Lesion tHb was not associated with 3-month complete response (CR), but StO2 was higher in patients with CR. In tongue/FOM lesions, baseline StO2 [mean(SE)] was 54(4)% in patients (n=12) with CR versus 23(8)% in patients (n=6) with local recurrence/persistence (p=0.01). Similarly, for intact disease, baseline StO2 was 54(3)% in patients (n=10) with CR versus 28(8)% in patients (n=5) without CR (p=0.03). In patients with intact disease, higher baseline StO2 associated with 24-month local control (p=0.02). CONCLUSIONS Measurement of the physiologic properties of target lesions may allow for identification of patients with the highest probability of benefiting from PDT. This provides opportunity for optimizing light delivery based on lesion characteristics and/or informing ongoing clinical decision-making in patients who would most benefit from PDT.
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Photodynamic therapy in oral potentially malignant disorders-Critical literature review of existing protocols. Photodiagnosis Photodyn Ther 2017; 20:125-129. [PMID: 28918177 DOI: 10.1016/j.pdpdt.2017.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 07/21/2017] [Accepted: 09/12/2017] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Oral cancer is a serious public health issue. Apart from its high rate of prevalence, incidence and mortality, it can often result in more complex and expensive treatment when diagnosed late. Potentially malignant disorders (PMDs) can precede oral cancer, and are usually treated by surgical excision. However, in many cases patients are elderly and multiple interventions may be required. Photodynamic therapy (PDT) is a simple alternative, which has been successfully used in the treatment of oral PMDs. OBJECTIVE Due to the lack of standardization regarding photosensitizers (PTSs), types of irradiation, and methods of application, the objective of this study was to analyze existing PDT protocols in an attempt to identify the one that demonstrates greater efficiency, reliability and feasibility in the treatment of oral PMDs for both researchers and clinicians. METHODS Original clinical studies published only in English between 1993 and 2016 were searched in Pubmed/Medline database using the following keywords: photodynamic therapy; oral potentially malignant disorder; oral premalignant lesions. Review articles; experimental studies; case-reports; commentaries; and letters to the Editor were excluded from the selection. RESULTS AND CONCLUSION Based on the 16 studies selected, the topical 5-ALA-20% PTS, associated to a LED light applied for 15min with a 7-day interval between sessions emerged as the most frequently used PDT protocol, with satisfactory results. Due to its low rate of side effects, this PDT protocol presents good potential for the treatment of oral PMDs. Further clinical studies are required to ascertain its long-term validity in preventing oral cancer.
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Gondivkar SM, Gadbail AR, Choudhary MG, Vedpathak PR, Likhitkar MS. Photodynamic treatment outcomes of potentially-malignant lesions and malignancies of the head and neck region: A systematic review. ACTA ACUST UNITED AC 2017; 9. [PMID: 28480637 DOI: 10.1111/jicd.12270] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 02/28/2017] [Indexed: 01/19/2023]
Abstract
AIM The aim of the present study was to systematically review the efficacy of photodynamic therapy (PDT) in the management of oral potentially-malignant disorders (PMDS) and head and neck squamous cell carcinoma (HNSCC). METHODS From 1985 to 2015, PubMed/Medline, Google Scholar, EMBASE, and ISI Web of Knowledge were searched using different combinations of the following key words: PDT, oral precancer, leukoplakia, erythroplakia, erythroleukoplakia, verrucous hyperplasia, oral submucous fibrosis, and HNSCC. Review articles, experimental studies, case reports, commentaries, letters to the editor, unpublished articles, and articles published in languages other than English were excluded. RESULTS Twenty-six studies were included in the present study. The number of patients ranged from 2 to 147, with a mean age of 50-67 years. The reported numbers of PMDS and HNSCC ranged between 5 and 225. Photosensitizers used were aminolevulinic acid, meta-tetrahydroxyphenylchlorin, Foscan, hematoporphyrin derivatives, Photofrin, Photosan, and chlorine-e6. Laser wavelength, power density, irradiation duration were 585-652 nm, 50-500 mW/cm2 , and 1-143 minutes, respectively. Complete, partial, and no response to PDT was found in 22.58%-100%, 4%-66%, and 0%-38.70% of PMDS, respectively, and 16%-100% of complete response in HNSCC patients. CONCLUSION PDT is effective in the management of PMDS and HNSCC.
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Affiliation(s)
- Shailesh M Gondivkar
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Amol Ramchandra Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India
| | - Manjari G Choudhary
- Department of Oral Medicine and Radiology, Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hirey Dental College and Hospital, Nashik, Maharashtra, India
| | - Priyanka R Vedpathak
- Department of Oral Medicine and Radiology, Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hirey Dental College and Hospital, Nashik, Maharashtra, India
| | - Manoj S Likhitkar
- Department of Conservative and Endodontics, HSRS Dental College and Hospital, Hingoli, Maharashtra, India
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Topical agents for oral cancer chemoprevention: A systematic review of the literature. Oral Oncol 2017; 67:153-159. [PMID: 28351570 DOI: 10.1016/j.oraloncology.2017.02.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 02/12/2017] [Accepted: 02/20/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVES/HYPOTHESIS We review the use of topical chemoprevention agents in patients with oral potentially malignant disorders (PMD). METHODS A systematic review of studies on topical chemoprevention agents for oral PMD from 1946 to November 2016 was conducted using the MEDLINE database, Embase, and Cochrane Library. Data were extracted and analyzed from selected studies including study type, sample size, demographics, treatment length, response rate, follow-up time, adverse effects, and recurrence. RESULTS Of 108 studies, twenty-four, representing 679 cases met the inclusion criteria. The clinical lesions evaluated included oral leukoplakia, erythroplakia (OEL), verrucous hyperplasia (OVH), oral lichen planus, larynx squamous cell carcinoma, and oral squamous cell carcinoma (OSCC). The mean complete response rate for topical retinoid therapy was 32%. The mean complete response rate for 1% bleomycin therapy and 0.5% bleomycin was 40.2% and 25%, respectively. The complete response rate of OVH, OEL, and OSCC to photodynamic therapy ranged from 66.7% to 100%. CONCLUSION There are a paucity of data examining topical treatment of oral PMDs. However, the use of topical agents among patients with oral lesions may be a viable complement or even alternative to traditional surgery, radiation, or systemic chemotherapy, with the advantage of reducing systemic side effects and sparing important anatomic structures. This study of 679 cases represents the largest pooled sample size to date, and the preliminary studies in this systematic review provide support for further inquiry.
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Abstract
Photodynamic therapy (PDT), also known as photoradiation therapy, phototherapy, or photochemo-therapy, involves the use of a photoactive dye (photosensitizer) that is activated by exposure to light of a specific wavelength in the presence of oxygen. The transfer of energy from the activated photosensitizer to available oxygen results in the formation of toxic oxygen species, such as singlet oxygen and free radicals. These very reactive chemical species can damage proteins, lipids, nucleic acids, and other cellular components. Applications of PDT in dentistry are growing rapidly: the treatment of oral cancer, bacterial and fungal infection therapies, and the photodynamic diagnosis (PDD) of the malignant transformation of oral lesions. PDT has shown potential in the treatment of oral leukoplakia, oral lichen planus, and head and neck cancer. Photodynamic antimicrobial chemotherapy (PACT) has been efficacious in the treatment of bacterial, fungal, parasitic, and viral infections. The absence of genotoxic and mutagenic effects of PDT is an important factor for long-term safety during treatment. PDT also represents a novel therapeutic approach in the management of oral biofilms. Disruption of plaque structure has important consequences for homeostasis within the biofilm. Studies are now leading toward selective photosensitizers, since killing the entire flora leaves patients open to opportunistic infections. Dentists deal with oral infections on a regular basis. The oral cavity is especially suitable for PACT, because it is relatively accessible to illumination.
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Affiliation(s)
- K Konopka
- Department of Microbiology, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
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Andreadis D, Pavlou AM, Sotiriou E, Vrani F, Ioannides D, Kolokotronis A. Utility of photodynamic therapy for the management of oral potentially malignant disorders and oral cancer. TRANSLATIONAL RESEARCH IN ORAL ONCOLOGY 2016. [DOI: 10.1177/2057178x16669161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Photodynamic therapy (PDT), defined as “the light-induced inactivation of cells, microorganisms, or molecules,” combines the use of a photosensitive agent or photosensitizer (PS) activated by irradiation with a light source to produce reactive oxygen species and highly reactive singlet oxygen. PDT has been used for the treatment of different oral diseases with promising results. This review describes the basic principles of PDT, including the nature of PS and the light sources, and focuses on evaluating the efficacy of this method, according to the existing data, for the treatment of different oral diseases. PubMed was used as the source of the relevant literature, about the clinical application of PDT in actinic cheilitis (AC), leukoplakia, oral lichen planus, oral lichenoid lesions, and oral cancer. Complete response to PDT as high as 100% has been reported not only in cases of AC but also in dysplasias/carcinomas in situ, T1N0, and T2N0. According to the available data, PDT appears to be a safe, well-tolerated therapy with limited adverse effects and excellent cosmetic outcome. Although PDT is a very promising therapy, further research is needed in order to investigate the cases that fail to respond, to examine the long-term prognosis for cases of reported complete response and thus avoid the future recurrence of diseases.
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Affiliation(s)
- Dimitrios Andreadis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Achilleia-Maria Pavlou
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Sotiriou
- First Department of Dermatology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fani Vrani
- First Department of Dermatology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Ioannides
- First Department of Dermatology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Kolokotronis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Proposal of thermal imaging application in photodynamic therapy—Preliminary report. Photodiagnosis Photodyn Ther 2016; 14:34-9. [DOI: 10.1016/j.pdpdt.2015.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 11/17/2015] [Accepted: 12/08/2015] [Indexed: 01/05/2023]
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Maloth KN, Velpula N, Kodangal S, Sangmesh M, Vellamchetla K, Ugrappa S, Meka N. Photodynamic Therapy - A Non-invasive Treatment Modality for Precancerous Lesions. J Lasers Med Sci 2016; 7:30-6. [PMID: 27330695 DOI: 10.15171/jlms.2016.07] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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 non-invasive 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.
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Affiliation(s)
- Kotya Naik Maloth
- Department of Oral Medicine and Radiology, Mamata Dental College and Hospital, Khammam, Telangana, India
| | - Nagalaxmi Velpula
- Department of Oral Medicine and Radiology, Sri Sai College Of Dental Surgery, Vikarabad, Telangana, India
| | - Srikanth Kodangal
- Department of Oral Medicine and Radiology, Sri Sai College Of Dental Surgery, Vikarabad, Telangana, India
| | - Mithare Sangmesh
- Department of Oral Medicine and Radiology, HKDE Trust's Dental College and Hospital, Humnabad, India
| | - Kiran Vellamchetla
- Oral Medicine and Radiology, Clinical Practitioner, Kiran Dental Hospital, KPHB Colony, Hyderabad, Telangana, India
| | - Sridevi Ugrappa
- Lecturer, Faculty Of Dentistry, Aimst Dental Institute, Aimst University, Semeling, 08100, Bedong, Malaysia
| | - Nagajyothi Meka
- Department of Oral Medicine and Radiology, Dr. Hedgewar Smruti Runga Seva Mandals Dental College and Hospital, Hingoli, Maharashtra, India
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Saini R, Poh CF. Photodynamic therapy: a review and its prospective role in the management of oral potentially malignant disorders. Oral Dis 2015; 19:440-51. [PMID: 24079944 DOI: 10.1111/odi.12003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 07/24/2012] [Accepted: 07/25/2012] [Indexed: 01/25/2023]
Abstract
With the unreliability of epithelial dysplasia as a predictor to determine the risk of future malignant development, subjectivity associated in evaluating dysplasia by pathologists and paucity of biomarkers that could accurately predict the progression risks in oral potentially malignant disorders (PMDs), eradication of the lesions appears to be the most desirable approach to minimize the risk of invasive cancer formation. Interventions, such as surgery and chemoprevention, have not shown promising long-term results in the treatment of these lesions, and lack of guidelines and general consensus on their management has incited much anxiety and doubts in both patients and community clinicians. Topical photodynamic therapy (PDT) is a minimally invasive and minimally toxic technique that in recent years has shown great promise in the management of PMDs. In this review, we describe the historical developments in the field of PDT, its basic mechanisms, as well as related clinical studies, and its challenges in the management of oral PMDs. Based on its high efficacy and low side effects, its high patient acceptance/compliance, the simplicity of the procedure and its minimal pretreatment preparation, topical PDT is believed to have potential to play an important role in the management of PMDs, especially of the low-grade dysplasia.
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Affiliation(s)
- R Saini
- Department of Integrative Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada; Faculty of Dentistry, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, BC, Canada
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Mostafa D, Tarakji B. Photodynamic therapy in treatment of oral lichen planus. J Clin Med Res 2015; 7:393-9. [PMID: 25883701 PMCID: PMC4394911 DOI: 10.14740/jocmr2147w] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2015] [Indexed: 12/18/2022] Open
Abstract
Oral lichen planus (OLP) is a relatively common chronic immunologic mucocutaneous disorder. Although there are many presenting treatments, some of them proved its failure. Recently, the use of photodynamic therapy (PDT) has been expanding due to its numerous advantages, as it is safe, convenient, and non-invasive and has toxic effect towards selective tissues. This article provides comprehensive review on OLP, its etiology, clinical features and recent non-pharmacological treatments. We also describe the topical PDT and its mechanisms. Our purpose was to evaluate the efficacy of PDT in treatment of OLP through collecting the data of the related clinical studies. We searched in PubMed website for the clinical studies that were reported from 2000 to 2014 using specific keywords: "photodynamic therapy" and "treatment of oral lichen planus". Inclusion criteria were English publications only were concerned. In the selected studies of photodynamic treatment, adult patients (more than 20 years) were conducted and the OLP lesions were clinically and histologically confirmed. Exclusion criteria were classical and pharmacological treatments of OLP were excluded and also the using of PDT on skin lesions of lichen planus. We established five clinical studies in this review where all of them reported improvement and effectiveness of PDT in treatment of OLP lesions. The main outcome of comparing the related clinical studies is that the photodynamic is considered as a safe, effective and promising treatment modality for OLP.
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Affiliation(s)
- Diana Mostafa
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Kingdom of Saudi Arabia
| | - Bassel Tarakji
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Kingdom of Saudi Arabia
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Vohra F, Al-Kheraif AA, Qadri T, Hassan MIA, Ahmed A, Warnakulasuriya S, Javed F. Efficacy of photodynamic therapy in the management of oral premalignant lesions. A systematic review. Photodiagnosis Photodyn Ther 2014; 12:150-9. [PMID: 25315968 DOI: 10.1016/j.pdpdt.2014.10.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 09/26/2014] [Accepted: 10/01/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim was to systematically review the efficacy of photodynamic therapy (PDT) in the management of oral premalignant lesions. METHODS The addressed focused question was "Is PDT effective in the management of oral premalignant lesions?" PubMed/Medline, Google-Scholar, EMBASE and ISI Web of Knowledge databases were searched from 1984 till June 2014 using different combinations of the following keywords: photodynamic therapy; oral premalignant lesions; leukoplakia; erythroplakia; erythro-leukoplakia; verrucous hyperplasia; and submucous fibrosis. Review articles, experimental studies, case-reports, commentaries, letters to the Editor, unpublished articles and articles published in languages other than English were not sought. The pattern of the present study was customized to mainly summarize the relevant information. RESULTS Thirteen studies were included. In these studies, the number of patients ranged between 5 patients and 147 individuals with mean ages ranging between 51 years and 62.2 years. Oral premalignant lesions, which were investigated were leukoplakia, erythroplakia, erythro-leukoplakia and verrucous hyperplasia. Reported number of premalignant lesions ranged between 5 and 225. Laser wavelength, duration of irradiation and power density were 585-660nm, 60s to 16.6min and 100-150mW/cm(2), respectively. Aminolevulinic acid, chlorine-e6, meta-tetrahydroxyphenylchlorin and photofrin were used as photosensitizer. The frequency of PDT application ranged between once and 12 times. Complete, partial and no response to PDT was shown by 27-100%, 5-50% and 0-25% of pre-malignant lesions, respectively. The recurrence rate of pre-malignant lesions was up to 36%. CONCLUSION PDT is effective in the overall management of oral premalignant lesions.
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Affiliation(s)
- Fahim Vohra
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz A Al-Kheraif
- Dental Biomaterials Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11541, Saudi Arabia
| | - Talat Qadri
- Division of Periodontology, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | | | - Asma Ahmed
- Department of Laser Dentistry, RWTH Aachen University, Aachen, Germany; Department of Dentistry, Lifecare Hospital, Abu Dhabi, United Arab Emirates
| | - Saman Warnakulasuriya
- Department of Oral Medicine, King's College London and WHO Collaborating Centre for Oral Cancer and Precancer, London, United Kingdom
| | - Fawad Javed
- Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
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Yang DF, Lee JW, Chen HM, Hsu YC. Topical methotrexate pretreatment enhances the therapeutic effect of topical 5-aminolevulinic acid-mediated photodynamic therapy on hamster buccal pouch precancers. J Formos Med Assoc 2014; 113:591-9. [DOI: 10.1016/j.jfma.2014.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 02/24/2014] [Accepted: 03/19/2014] [Indexed: 12/13/2022] Open
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Gillenwater AM, Vigneswaran N, Fatani H, Saintigny P, El-Naggar AK. Proliferative verrucous leukoplakia: recognition and differentiation from conventional leukoplakia and mimics. Head Neck 2014; 36:1662-8. [PMID: 24115154 DOI: 10.1002/hed.23505] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 09/14/2012] [Accepted: 09/10/2013] [Indexed: 12/24/2022] Open
Abstract
The majority of conventional leukoplakia remains constant and only a subset progress to high-grade dysplasia or invasive carcinoma. A less recognized form known as proliferative verrucous leukoplakia (PVL) represents a unique progressive and elusive variant. Identifying patients with this form can only be achieved through the keen clinical observation of the temporal gross and histologic progression in individual patients with squamous cell carcinoma. The difficulty in the early diagnosis of PVL stems from the overlapping clinical and pathologic features with conventional multifocal leukoplakia with dysplasia. We present the current view on the clinicopathologic and biological characteristics of PVL and discuss their diagnosis, differential diagnosis, and management.
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Affiliation(s)
- Ann M Gillenwater
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Costa IDSM, Abranches RP, Garcia MTJ, Pierre MBR. Chitosan-based mucoadhesive films containing 5-aminolevulinic acid for buccal cancer's treatment. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2014; 140:266-75. [PMID: 25190225 DOI: 10.1016/j.jphotobiol.2014.08.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 07/22/2014] [Accepted: 08/05/2014] [Indexed: 02/04/2023]
Abstract
Photodynamic therapy (PDT) is a relatively new method to treat various kinds of tumors, including those of the oral cavity. The topical 5-ALA-PDT treatment for tumors of the oral mucosa is preferred, since when administered systemically, there is a general photosensitization drawback in the patient. However, 5-ALA is a hydrophilic molecule and its penetration and retention is limited by topical route, including oral mucosa. We propose a topical delivery system of chitosan-based mucoadhesive film, aiming to promote greater retention of 5-ALA in tissue. The chitosan (CHT) films (4% w/w) were prepared using the solvent evaporation/casting technique. They were tested without 5-ALA resulting in permeability to water vapor (W.V.P=2.15-8.54 g mm/(h cm(2)Pa) swelling ∼300.0% (±10.5) at 4 h or 24 h and in vitro residence time >24 h for all tests. CHT films containing 10.0% (w/w) 5-ALA have resulted in average weight of 0.22 g and thickness of 0.608 mm as suitable characteristics for oral application. In the presence of CHT films both in vitro permeation and retention of 5-ALA (1.0% or 10.0%) were increased. However, 10.0% 5-ALA presented highest values of permeation and retention (∼4 and 17 times respectively, compared to propylene glycol vehicle). On the other hand, in vitro mucoadhesion of CHT films was decreased (18.2-fold and 3.1-fold) by 5-ALA addition (1.0% or 10.0% respectively). However, CHT film containing 10.0% of 5-ALA can be a potential delivery system for topical use in the treatment of tumors of the oral cavity using PDT because it favored the retention of 5-ALA in this tissue and has shown convenient mucoadhesion.
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Affiliation(s)
- Irina dos Santos Miranda Costa
- School of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho 373, 21.941.902 Rio de Janeiro, RJ, Brazil
| | - Renata Pereira Abranches
- School of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho 373, 21.941.902 Rio de Janeiro, RJ, Brazil
| | - Maria Teresa Junqueira Garcia
- School of Pharmacy, University of Uberaba, Av. Nenê Sabino, 1801, Bairro Universitário, 38055-500 Uberaba, MG, Brazil
| | - Maria Bernadete Riemma Pierre
- School of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho 373, 21.941.902 Rio de Janeiro, RJ, Brazil.
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Yang DF, Lee JW, Chen HM, Huang Z, Hsu YC. Methotrexate enhances 5-aminolevulinic acid-mediated photodynamic therapy-induced killing of human SCC4 cells by upregulation of coproporphyrinogen oxidase. J Formos Med Assoc 2014; 113:88-93. [PMID: 24485831 DOI: 10.1016/j.jfma.2013.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 12/24/2013] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND/PURPOSE Topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is effective for treatment of oral precancerous and cancerous lesions. This in vitro study tried to examine whether the SCC4 cell killing by ALA-PDT was enhanced by pretreatment of methotrexate (MTX). METHODS To measure the SCC4 cell killing abilities by MTX-pretreated ALA-PDT (MTX-ALA-PDT), the SCC4 cells were pretreated with 0 mg/L, 0.001 mg/L, 0.01 mg/L, 0.1 mg/L, or 1 mg/L of MTX for 72 hours, then incubated with 0 mM, 0.0625 mM, 0.125 mM, 0.187 mM, 0.25 mM, or 0.375 mM ALA for 4 hours, and subsequently illuminated with a 640-nm light-emitting diode array at a light dose of 10 J/cm(2). The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was conducted at 24 hours to quantify SCC4 cell survival rates after MTX-ALA-PDT treatment. Western blot analyses were used to examine the MTX-mediated enhancement in the expressions of the heme production-related enzymes, coproporphyrinogen oxidase (CPOX), protoporphyrinogen oxidase (PPOX), and ferrochelatase, in the MTX-preconditioned SCC4 cells. RESULTS Pretreatment of SCC4 cells by 0.001 mg/L MTX for 72 hours resulted in a significant augmentation in MTX-ALA-PDT-induced killing of SCC4 cells (p < 0.05). The SCC4 cells treated with 0.001 mg/L MTX for 72 hours showed a significant and 1.65-fold increase in CPOX expression compared with the control SCC4 cells without MTX treatment (p < 0.05). However, no significant changes in the expressions of PPOX and ferrochelatase were observed in the SCC4 cells pretreated with different concentrations of MTX. CONCLUSION MTX enhances ALA-PDT-induced SCC4 cell killing through upregulation of CPOX expression and subsequent increase in intracellular protoporphyrin IX production in SCC4 cells.
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Affiliation(s)
- Deng-Fu Yang
- Graduate Program, Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Jeng-Woei Lee
- Department of Life Science, Tzu Chi University, Hualien, Taiwan
| | - Hsin-Ming Chen
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Zheng Huang
- Cancer Center, University of Colorado Denver Cancer Center, CO, USA
| | - Yih-Chih Hsu
- Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan, Taiwan; Center for Nanotechnology, Chung Yuan Christian University, Taoyuan, Taiwan; Center of Biomedical Technology, Chung Yuan Christian University, Taoyuan, Taiwan.
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Pietruska M, Sobaniec S, Bernaczyk P, Cholewa M, Pietruski JK, Dolińska E, Skurska A, Duraj E, Tokajuk G. Clinical evaluation of photodynamic therapy efficacy in the treatment of oral leukoplakia. Photodiagnosis Photodyn Ther 2013; 11:34-40. [PMID: 24211597 DOI: 10.1016/j.pdpdt.2013.10.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 10/19/2013] [Accepted: 10/26/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aim of the study was clinical evaluation of photodynamic therapy efficacy in the treatment of oral leukoplakia lesions. METHODS Twenty-three consecutive patients aged 21-79 were included to the study. In all patients 44 homogeneous, flat leukoplakia lesions were clinically diagnosed and confirmed histopathologically. Photodynamic therapy was performed with the use of Photolon(®) photosensitizer, containing 20% Chlorine-e6 and 10% dimethyl sulfoxide and a semiconductor laser, with power up to 300mW and a wavelength of 660nm. Ten illumination sessions were conducted with the use of superficial light energy density of 90J/cm(2). RESULTS At baseline the mean size of leukoplakia lesion was 6.5±5.10cm(2) while after photodynamic therapy 3±2.99cm(2). Significant reduction (on average by 53.8%) of leukoplakia lesions sizes was observed after therapy. Twelve (27.27%) lesions had been completely cured, 22 (50%) partially cured, although 10 (22.73%) lasted unchanged. The efficacy of PTD was comparable in women and men irrespective of age. There have been no adverse site effects during therapy noted. CONCLUSIONS Within the limits of the study it can be concluded that photodynamic therapy with the use of Chlorine-e6 can lead to considerable reduction of oral leukoplakia lesions size thus may be useful in clinical practice. However there is a need of further studies on larger number of cases and longer follow-up time.
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Affiliation(s)
- Małgorzata Pietruska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland; Dental Practice, ul. Waszyngtona 1/34, 15-269 Białystok, Poland.
| | - Stefan Sobaniec
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland
| | - Piotr Bernaczyk
- Department of Medical Pathomorphology, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland
| | - Magdalena Cholewa
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland
| | - Jan Krzysztof Pietruski
- Department of Medical Pathomorphology, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland
| | - Ewa Dolińska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland
| | - Anna Skurska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland; Department of Medical Pathomorphology, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland
| | - Ewa Duraj
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland
| | - Grażyna Tokajuk
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland
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Wong SJ, Campbell B, Massey B, Lynch DP, Cohen EEW, Blair E, Selle R, Shklovskaya J, Jovanovic BD, Skripkauskas S, Dew A, Kulesza P, Parimi V, Bergan RC, Szabo E. A phase I trial of aminolevulinic acid-photodynamic therapy for treatment of oral leukoplakia. Oral Oncol 2013; 49:970-976. [PMID: 23845699 PMCID: PMC4456032 DOI: 10.1016/j.oraloncology.2013.05.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 05/24/2013] [Accepted: 05/30/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND Photodynamic therapy with aminolevulinic acid (ALA PDT) for oral leukoplakia has shown promising effects in regression of oral leukoplakia. Although ALA has been extensively studied and is an ideal photosensitizer, the optimal light dose for treatment of oral leukoplakia has not been determined. We conducted a phase I study to determine MTD and DLT of PDT in patients treated with ALA for leukoplakia. METHODS Patients with histologically confirmed oral leukoplakia received a single treatment of ALA PDT in cohorts with escalating doses of light (585nm). Clinical, histologic, and biologic markers were assessed. RESULTS Analysis of 11 participants is reported. No significant toxicity from ALA PDT was observed in patients who received ALA with a light dose of up to 4J/cm(2). One participant experienced transient grade 3 transaminase elevation due to ALA. One participant had a partial clinical response 3months after treatment. Biologic mucosal risk markers showed no significant associations. Determination of MTD could not be accomplished within a feasible timeframe for completion of the study. CONCLUSIONS ALA PDT could be safely administered with a light dose up to 4J/cm(2) and demonstrated activity. Larger studies are needed to fully elucidate the MTD and efficacy of ALA-PDT.
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Affiliation(s)
- Stuart J Wong
- Medical College of Wisconsin, Milwaukee, Wisconsin, United States.
| | - Bruce Campbell
- Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Becky Massey
- Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Denis P Lynch
- Marquette University School of Dentistry, Milwaukee, Wisconsin, United States
| | - Ezra E W Cohen
- University of Chicago Comprehensive Cancer Center, Chicago, Illinois, United States
| | - Elizabeth Blair
- University of Chicago Comprehensive Cancer Center, Chicago, Illinois, United States
| | - Rebecca Selle
- Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | | | | | | | | | | | | | - Raymond C Bergan
- Robert H. Lurie Cancer Center, United States; Center for Molecular Innovation and Drug Discovery of Northwestern University, Chicago, Illinois, United States
| | - Eva Szabo
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Chicago, Illinois, United States
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Sieroń A, Sieroń-Stołtny K, Kawczyk-Krupka A, Latos W, Kwiatek S, Straszak D, Bugaj AM. The role of fluorescence diagnosis in clinical practice. Onco Targets Ther 2013; 6:977-82. [PMID: 23935372 PMCID: PMC3735341 DOI: 10.2147/ott.s42074] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Fluorescence diagnosis is a fast, easy, noninvasive, selective, and sensitive diagnostic tool for estimation of treatment results in oncology. In clinical practice the use of photodynamic diagnosis is focused on five targets: detection for prevention of malignant transformation precancerous changes, detection of neoplasmatic tissue in the early stages for fast removal, prevention of expansion and detection of recurrence of the cancer, monitoring therapy, and the possibility of excluding neoplasmatic disease. In this article, selected applications of fluorescence diagnosis at the Center for Laser Diagnostics and Therapy in Bytom, Poland, for each of these targets are presented.
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Affiliation(s)
- Aleksander Sieroń
- Clinical Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Silesian Medical University, Bytom
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Garcia VG, Gualberto Júnior EC, Fernandes LA, Bosco AF, Hitomi Nagata MJ, Casatti CA, Ervolino E, Theodoro LH. Adjunctive Antimicrobial Photodynamic Treatment of Experimentally Induced Periodontitis in Rats With Ovariectomy. J Periodontol 2013; 84:556-65. [DOI: 10.1902/jop.2012.120163] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Milla Sanabria L, Rodríguez ME, Cogno IS, Rumie Vittar NB, Pansa MF, Lamberti MJ, Rivarola VA. Direct and indirect photodynamic therapy effects on the cellular and molecular components of the tumor microenvironment. Biochim Biophys Acta Rev Cancer 2012; 1835:36-45. [PMID: 23046998 DOI: 10.1016/j.bbcan.2012.10.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 09/28/2012] [Accepted: 10/01/2012] [Indexed: 12/31/2022]
Abstract
Photodynamic therapy (PDT) is a novel cancer treatment. It involves the activation of a photosensitizer (PS) with light of specific wavelength, which interacts with molecular oxygen to generate singlet oxygen and other reactive oxygen species (ROS) that lead to tumor cell death. When a tumor is treated with PDT, in addition to affect cancer cells, the extracellular matrix and the other cellular components of the microenvironment are altered and finally this had effects on the tumor cells survival. Furthermore, the heterogeneity in the availability of nutrients and oxygen in the different regions of a tridimensional tumor has a strong impact on the sensitivity of cells to PDT. In this review, we summarize how PDT affects indirectly to the tumor cells, by the alterations on the extracellular matrix, the cell adhesion and the effects over the immune response. Also, we describe direct PDT effects on cancer cells, considering the intratumoral role that autophagy mediated by hypoxia-inducible factor 1 (HIF-1) has on the efficiency of the treatment.
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Affiliation(s)
- Laura Milla Sanabria
- Department of Molecular Biology, National University of Río Cuarto, Río Cuarto (5800), Córdoba, Argentina
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Yu CH, Chen HM, Lin HP, Chiang CP. Expression of Bak and Bak/Mcl-1 ratio can predict photodynamic therapy outcome for oral verrucous hyperplasia and leukoplakia. J Oral Pathol Med 2012; 42:257-62. [DOI: 10.1111/jop.12007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Chuan-Hang Yu
- School of Dentistry; College of Oral Medicine; Chung Shan Medical University; Taichung Taiwan
- Department of Dentistry; Oral Medicine Center; Chung Shan Medical University Hospital; Taichung Taiwan
| | - Hsin-Ming Chen
- Graduate Institute of Oral Biology; School of Dentistry; National Taiwan University; Taipei Taiwan
- Graduate Institute of Clinical Dentistry; School of Dentistry; National Taiwan University; Taipei Taiwan
- Department of Dentistry; National Taiwan University Hospital; College of Medicine; National Taiwan University; Taipei Taiwan
| | - Hung-Pin Lin
- Graduate Institute of Clinical Dentistry; School of Dentistry; National Taiwan University; Taipei Taiwan
- Department of Dentistry; National Taiwan University Hospital; College of Medicine; National Taiwan University; Taipei Taiwan
| | - Chun-Pin Chiang
- Graduate Institute of Oral Biology; School of Dentistry; National Taiwan University; Taipei Taiwan
- Graduate Institute of Clinical Dentistry; School of Dentistry; National Taiwan University; Taipei Taiwan
- Department of Dentistry; National Taiwan University Hospital; College of Medicine; National Taiwan University; Taipei Taiwan
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Cholewka A, Stanek A, Kwiatek S, Sieroń A, Drzazga Z. Does the temperature gradient correlate with the photodynamic diagnosis parameter numerical colour value (NCV)? Photodiagnosis Photodyn Ther 2012; 10:33-8. [PMID: 23465370 DOI: 10.1016/j.pdpdt.2012.07.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Revised: 07/13/2012] [Accepted: 07/16/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Photodynamic diagnosis (PDD) as well as thermovision belong to the category of non-invasive optical diagnosis techniques. Among many different skin cancer diseases, basal cell carcinoma (BCC) is the most frequently occurring one (almost 95% of all skin tumours). In contrast, seborrhoeic keratosis represents almost 70% of benign skin tumours. In this paper we present infrared thermography as an additional method, combined with PDD, to show the differentiation between these two skin mutations. METHODS The photodynamic diagnosis studies were performed by using the autofluorescence diagnosis system Xillix Onco. As an additional non-invasive diagnosis technique, thermovision studies were performed. Thermal imaging was done by using a Thermovision Camera A40M with a sensitivity of 0.07K. The thermograms of the chosen areas were performed in a special room with a temperature of 22.5±1°C. All patients were treated in the Chair and Clinic of Internal Diseases, Angiology and Physical Medicine in Bytom. Thirteen skin lesions were studied: 9 diagnosed as basal cell carcinoma and 4 as seborrhoeic keratosis. All skin lesions were confirmed in histopathological examinations. RESULTS AND CONCLUSIONS The results of the studies revealed significant differences in skin thermal mapping between patients suffering from basal cell carcinoma and seborrhoeic keratosis. It appears that benign skin lesions are characterised by a lower mean temperature than the surrounding healthy skin. To the contrary, cancerous skin mutations appeared on the thermal map at a higher mean temperature. Thermal images for the chosen skin lesions and temperature parameters derived from the thermograms are contiguous with the photodynamic diagnosis results and may give some additional diagnostic information.
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Affiliation(s)
- Armand Cholewka
- Institute of Physics, Department of Medical Physics, University of Silesia, Uniwersytecka 4, 40-007 Katowice, Poland.
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Reappraisal of photodynamic therapy as first-line therapy in management of oral pre-malignant lesions. Oral Oncol 2012; 48:915-916. [PMID: 22633786 DOI: 10.1016/j.oraloncology.2012.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 04/30/2012] [Indexed: 11/20/2022]
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Hsu YC, Yang DF, Chiang CP, Lee JW, Tseng MK. Successful treatment of 7,12-dimethylbenz(a)anthracene-induced hamster buccal pouch precancerous lesions by topical 5-aminolevulinic acid-mediated photodynamic therapy. Photodiagnosis Photodyn Ther 2012. [PMID: 23200011 DOI: 10.1016/j.pdpdt.2012.03.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Our previous studies found that topical 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (ALA-PDT) with a light dose of 100 J/cm(2) is very effective for human oral precancerous lesions. METHODS In this study, 20 7,12-dimethylbenz(a)anthracene (DMBA)-induced hamster buccal pouch precancerous lesions were treated by topical ALA-PDT with a light dose of either 75 J/cm(2) (n = 10) or 100 J/cm(2) (n = 10) using a 640-nm light-emitting diode (LED) light to test which light dose could achieve a better clinical outcome. RESULTS The 10 precancerous lesions treated by 75-J ALA-PDT showed complete response in 8 after an average of 3.4 (range, 2-6) treatments and partial response in 2. The 10 precancerous lesions treated by 100-J ALA-PDT demonstrated complete response in 7 after an average of 4.4 (range, 3-6) treatments and partial response in 3. Fisher exact test showed no significant difference in clinical outcome between these two treatment modalities (p = 1.000). One complete-response precancerous lesion in the 75-J ALA-PDT group recurred at the end of 19-week follow-up and another complete response precancerous lesion in the 100-J ALA-PDT group recurred at the end of 16-week follow-up. Both recurrence lesions were treated by the original topical ALA-PDT regimen and demonstrated complete response after 3 PDT treatments. Furthermore, the 5 partial-response precancerous lesions developed into squamous cell carcinomas after 30-week follow-up. CONCLUSION Our findings indicate that both the 75-J and 100-J topical ALA-PDT treatment modalities are very effective for DMBA-induced hamster buccal pouch precancerous lesions and no significant difference in clinical outcome between these two treatment modalities.
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Affiliation(s)
- Yih-Chih Hsu
- Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan, Taiwan.
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Kawczyk-Krupka A, Waśkowska J, Raczkowska-Siostrzonek A, Kościarz-Grzesiok A, Kwiatek S, Straszak D, Latos W, Koszowski R, Sieroń A. Comparison of cryotherapy and photodynamic therapy in treatment of oral leukoplakia. Photodiagnosis Photodyn Ther 2012; 9:148-55. [PMID: 22594985 DOI: 10.1016/j.pdpdt.2011.12.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2011] [Revised: 12/06/2011] [Accepted: 12/10/2011] [Indexed: 02/07/2023]
Abstract
Oral leukoplakia is a pre-malignant lesion of the oral mucosa. The aim of this study is to compare the curative effects of photodynamic therapy and cryotherapy in the treatment of oral leukoplakia. The first group, treated by photodynamic therapy (δ-aminolevulinic acid (ALA), 630-635 nm wavelength), consisted of 48 patients suffering from leukoplakia. The second group consisted of 37 patients treated using cryotherapy. Analyses and comparisons of the complete responses, recurrences, numbers of procedures and adverse effects after both PDT and cryotherapy were obtained. In the first group, a complete response was obtained in 35 patients (72.9%), with thirteen recurrences observed (27.1%) over a six-month period. In the second group, a complete response was obtained in 33 patients (89.2%), and recurrence was observed in nine patients (24.3%). Photodynamic therapy and cryotherapy appear to be comparative methods of treatment that may both serve as alternatives for the traditional surgical treatment of oral leukoplakia. The advantages of PDT are connected with minimally invasive and localized character of the treatment and with not damage of collagenous tissue structures, therefore normal cells will repopulate these arrangements. PDT is more convenient for patients, less painful, and more esthetic.
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Affiliation(s)
- Aleksandra Kawczyk-Krupka
- Department and Clinic of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia, Batorego 15 St, 41-902 Bytom, Poland.
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Lin HP, Chen HM, Cheng SJ, Yu CH, Chiang CP. Cryogun cryotherapy for oral leukoplakia. Head Neck 2011; 34:1306-11. [DOI: 10.1002/hed.21912] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2011] [Indexed: 11/06/2022] Open
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Quon H, Grossman CE, Finlay JC, Zhu TC, Clemmens CS, Malloy KM, Busch TM. Photodynamic therapy in the management of pre-malignant head and neck mucosal dysplasia and microinvasive carcinoma. Photodiagnosis Photodyn Ther 2011; 8:75-85. [PMID: 21497298 DOI: 10.1016/j.pdpdt.2011.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 12/24/2010] [Accepted: 01/06/2011] [Indexed: 12/25/2022]
Abstract
The management of head and neck mucosal dysplasia and microinvasive carcinoma is an appealing strategy to prevent the development of invasive carcinomas. While surgery remains the standard of care, photodynamic therapy (PDT) offers several advantages including the ability to provide superficial yet wide field mucosal ablative treatment. This is particularly attractive where defining the extent of the dysplasia can be difficult. PDT can also retreat the mucosa without any cumulative fibrotic complications affecting function. To date, clinical experience suggests that this treatment approach can be effective in obtaining a complete response for the treated lesion but long term follow-up is limited. Further research efforts are needed to define not only the risk of malignant transformation with PDT but also to develop site specific treatment recommendations that include the fluence, fluence rate and light delivery technique.
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Affiliation(s)
- Harry Quon
- Department of Radiation Oncology, United States.
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45
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46
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Sankar V, Hearnden V, Hull K, Juras DV, Greenberg MS, Kerr AR, Lockhart PB, Patton LL, Porter S, Thornhill M. Local drug delivery for oral mucosal diseases: challenges and opportunities. Oral Dis 2011; 17 Suppl 1:73-84. [PMID: 21382140 DOI: 10.1111/j.1601-0825.2011.01793.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There are few topical formulations used for oral medicine applications most of which have been developed for the management of dermatological conditions. As such, numerous obstacles are faced when utilizing these preparations in the oral cavity, namely enzymatic degradation, taste, limited surface area, poor tissue penetration and accidental swallowing. In this review, we discuss common mucosal diseases such as oral cancer, mucositis, vesiculo-erosive conditions, infections, neuropathic pain and salivary dysfunction, which could benefit from topical delivery systems designed specifically for the oral mucosa, which are capable of sustained release. Each condition requires distinct penetration and drug retention profiles in order to optimize treatment and minimize side effects. Local drug delivery may provide a more targeted and efficient drug-delivery option than systemic delivery for diseases of the oral mucosa. We identify those mucosal diseases currently being treated, the challenges that must be overcome and the potential of novel therapies. Novel biological therapies such as macromolecular biological drugs, peptides and gene therapy may be of value in the treatment of many chronic oral conditions and thus in oral medicine if their delivery can be optimized.
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Affiliation(s)
- V Sankar
- Department of Comprehensive Dentistry, The University of Texas Health Science Center at San Antonio, TX, USA
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47
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Ge L, Shu R, Li Y, Li C, Luo L, Song Z, Xie Y, Liu D. Adjunctive Effect of Photodynamic Therapy to Scaling and Root Planing in the Treatment of Chronic Periodontitis. Photomed Laser Surg 2011; 29:33-7. [DOI: 10.1089/pho.2009.2727] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Linhua Ge
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
| | - Rong Shu
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
| | - Yiming Li
- School of Dentistry, Loma Linda University, Loma Linda, California
| | - Chaolun Li
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
| | - Lijun Luo
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
| | - Zhongchen Song
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
| | - Yufeng Xie
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
| | - Dali Liu
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
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Chen HM, Liu CM, Yang H, Chou HY, Chiang CP, Kuo MYP. 5-aminolevulinic acid induce apoptosis via NF-κB/JNK pathway in human oral cancer Ca9-22 cells. J Oral Pathol Med 2010; 40:483-9. [PMID: 21138480 DOI: 10.1111/j.1600-0714.2010.00973.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND 5-aminolevulinic acid-based photodynamic therapy (5-ALA-PDT) is being used to treat oral pre-cancerous and cancerous lesions with some encouraging clinical outcomes. However, the exact mechanisms behind the photodynamic treatment are still not fully elucidated. METHOD Flow cytometry, TdT-mediated dUTP nick end labeling assay and Western blot analysis were used to investigate the effects of 5-ALA-PDT on human oral cancer Ca9-22 cells. RESULTS We found that 5-ALA-PDT induces apoptosis in Ca9-22 cells. Western blotting showed that 5-ALA-PDT activates both the caspase-8 and caspase-9 pathways, which differed from previous studies conducted in other cell types. Activation of JNK was evident as early as 30 min. The caspases activation was inhibited by JNK inhibitor SP600125. Treatment with NF-κB inhibitor Bay 11-7082 (Bay) completely abrogated ALA-PDT-induced JNK activation. In addition, Bay and SP600125 almost completely abolished ALA-PDT-induced apoptosis. CONCLUSION These results demonstrate significant involvement of caspase-8 and -9 and their upstream NF-κB-JNK pathways in ALA-PDT-induced apoptosis. Future studies on how NF-κB and JNK activity regulate ALA-PDT response should provide a better strategy for the treatment of oral cancer.
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Affiliation(s)
- Hsin-Ming Chen
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
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Successful treatment of an early invasive oral squamous cell carcinoma with topical 5-aminolevulinic acid-mediated photodynamic therapy. J Dent Sci 2010. [DOI: 10.1016/s1991-7902(10)60006-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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A review of the nonsurgical treatment of oral leukoplakia. Int J Dent 2010; 2010:186018. [PMID: 20339486 PMCID: PMC2836849 DOI: 10.1155/2010/186018] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2009] [Revised: 11/26/2009] [Accepted: 01/13/2010] [Indexed: 02/07/2023] Open
Abstract
The aim of this paper was to assess the nonsurgical treatment of oral leukoplakia (OL). A medline search from 1983 to 2009 was conducted. The topical or systemic nonsurgical treatments or combination of both was reviewed. The primary outcomes of interest were clinical resolution, malignant transformation, follow-up, and recurrence of OL. Studies showed a rate higher than 50% of clinical resolution with photodynamic therapy, beta-carotene, lycopene, or vitamin A. Few studies reported rates of recurrence from 5 to 67% and of malignant transformation from 8 to 23%. There is a lack of randomized clinical trials that assess the effectiveness of nonsurgical treatment of OL. At this time, randomized controlled trials for nonsurgical treatment of OL demonstrate no evidence of effective treatment in preventing malignant transformation and recurrence. It reinforces that even after clinical resolution, OL should be regularly followed.
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