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首页> 外文会议>International Photodynamic Association World Congress >Photodynamic therapy for actinic keratosis: a trend towards a decrease in irradiance without loss of efficacy for a better tolerability
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Photodynamic therapy for actinic keratosis: a trend towards a decrease in irradiance without loss of efficacy for a better tolerability

机译：光学角膜症的光动力学治疗：辐照减少的趋势而不会损失效力，以更好的耐受性

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Photodynamic therapy (PDT) is an established treatment for actinic keratosis (AK). The conventional approved PDT protocol in Europe (C-PDT) involves red-light photoactivation at irradiances higher than 60 mW/cm~2, making the treatment painful. Several clinical studies have reported similar efficacy and better tolerability when using red-light photoactivation at lower irradiances. The aim of the study was to investigate whether there is a minimum irradiance threshold for red-light photoactivation above which there is no further improvement in efficacy. A photodiode sensor connected to a power meter was used to measure the irradiance delivered to 114 AKs on the scalp and forehead of 19 patients during C-PDT using the Aktilite CL 128 (Galderma SA, Switzerland). The widely ranging measured irradiances, resulting from the heterogeneous photoactivation over the treatment area provided by the Aktilite CL 128, were cross-referenced with the clinically evaluated complete responses (CR) at 3 months. The 66 AKs in CR at 3 months received an average irradiance of 30.9 mW/cm~2 (standard deviation: 16.7 mW/cm~2) compared to 33.3 mW/cm~2 (standard deviation: 17.9 mW/cm~2) for the 48 AKs in incomplete response. No significant effect of the irradiance on the CR at 3 months was found (odds ratio for a 6 mW/cm~2-unit change, 0.96; 95% confidence interval, 0.83 to 1.10; p=0.53). No minimum irradiance threshold could therefore be determined in the considered irradiance range. A red-light device enabling homogeneous irradiation at a lower irradiance than the Aktilite CL 128 may therefore provide similar efficacy and higher treatment tolerability than C-PDT.
机译：光动力疗法（PDT）是一种既定的光化角膜病（AK）的治疗方法。欧洲的常规批准的PDT协议（C-PDT）涉及在高于60mW / cm〜2的辐射的红光照相，使治疗疼痛。在较低的ImRIAnce中使用红光照相时，若干临床研究报告了类似的功效和更好的耐受性。该研究的目的是调查红色光拍摄是否存在最小辐照度阈值，其疗效没有进一步改善。使用Aktilite CL 128（Galderma SA，瑞士）在C-PDT期间测量连接到功率计的光电二极管传感器测量输送到114个AK的辐照度和19名患者的114 AK。由由Aktilite Cl 128提供的处理区域的异质光激活产生的广泛测量的辐射术在3个月内通过临床评估的完整反应（Cr）交叉参考。 3个月的CR中的66个AKS接受了30.9mW / cm〜2的平均辐照度（标准差：16.7mW / cm〜2），相比33.3 mw / cm〜2（标准差：17.9 mw / cm〜2） 48个AKS在不完整的响应中。发现辐照对Cr的辐照效果未发现（6mW / cm〜2单元的差值，0.96％; 95％置信区间，0.83至1.10; p = 0.53）。因此，在考虑的辐照度范围内无法确定最小辐照度阈值。因此，在低于Aktilite CL 128的较低辐照度下实现均匀照射的红光装置可以提供与C-PDT相似的疗效和更高的治疗耐受性。

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