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A review of pain experienced during topical photodynamic therapy-Our experience in Dundee

机译：局部光动力疗法过程中疼痛的回顾-我们在邓迪的经验

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Background: Topical photodynamic therapy (PDT) using 5-aminolaevutinic acid (ALA) and its methylated ester, methyl aminolevulinate (AAAL) is widely used to treat superficial non-melanoma skin cancer (NMSC). It has been proposed that ALA PDT is more painful than MAL PDT. The aim of this paper was to compare pain scores of MAL PDT with ALA PDT in our patients and to analyse the relationship between various parameters and pain during PDT. Methods: We retrospectively reviewed case notes and electronic records for all patients with superficial NMSC treated with PDT from June 2007 to March 2009. Results: On univariate analysis of patients with single lesions only, we observed no association between pain and lesion diameter or pro-drug or dose or diagnosis. Pre-treatment PplX fluorescence was significantly associated with pain. However on univariate analysis of all patients (whether single or multiple lesions) treated with PDT, MAL was associated with significantly less pain than ALA. When all the recorded variables were taken into account (multivariate analysis), diagnosis, pre-treatment PplX fluorescence and lesion diameter were associated with pain. Conclusions: Our data lends some support to previous published reports suggesting that the MAL PDT regime is less painful than that for ALA PDT. However, PDT pain is multifactorial and choice of photosensitiser is probably not a major pain determining factor. A prospective randomised study, with the same incubation periods for each pro-drug, is needed to definitively answer the question as to whether or not MAL PDT causes less pain than ALA PDT.
机译：背景：使用5-氨基松香酸（ALA）及其甲基化酯，氨基乙酰丙酸甲酯（AAAL）的局部光动力疗法（PDT）被广泛用于治疗浅表性非黑素瘤皮肤癌（NMSC）。已经提出，ALA PDT比MAL PDT更痛苦。本文的目的是比较我们患者中MAL PDT和ALA PDT的疼痛评分，并分析PDT期间各种参数与疼痛之间的关系。方法：我们回顾性回顾了2007年6月至2009年3月所有接受PDT治疗的浅表NMSC患者的病例记录和电子记录。结果：仅对单病灶的患者进行单变量分析，我们观察到疼痛与病灶直径或病程无相关性。药物，剂量或诊断。治疗前PplX荧光与疼痛显着相关。但是，对所有接受PDT治疗的患者（无论是单个病变还是多个病变）进行单因素分析，与ALA相比，MAL带来的疼痛明显减轻。当考虑所有记录的变量（多变量分析）时，诊断，治疗前PplX荧光和病变直径与疼痛有关。结论：我们的数据为先前发表的报告提供了一些支持，表明MAL PDT方案不如ALA PDT那样痛苦。但是，PDT疼痛是多因素的，选择光敏剂可能不是决定疼痛的主要因素。需要一项前瞻性随机研究，每个前药的潜伏期相同，以明确回答MAL PDT引起的疼痛是否比ALA PDT少的问题。

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