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首页> 外文期刊>Photodiagnosis and Photodynamic Therapy >Daylight versus conventional photodynamic therapy for the treatment of actinic keratosis: A meta-analysis of randomized controlled trials
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Daylight versus conventional photodynamic therapy for the treatment of actinic keratosis: A meta-analysis of randomized controlled trials

机译：日光与常规光动力疗法治疗光化性角化病：随机对照试验的荟萃分析

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Daylight photodynamic therapy (dPDT) is suggested to be effective for actinic keratosis (AK). We performed a meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of dPDT versus conventional photodynamic therapy (cPDT) in patients with AK. Relevant studies were identified through a systematic search of PubMed, Embase, and the Cochrane Library. A fixed or random effect model was applied, depending on the heterogeneity. Six RCTs with 369 patients with 5,556 AK lesions that were undergoing dPDT or cPDT with red light and methyl aminolevulinate (MAL) were included. Overall, the incidence of complete response (CR) was not significantly different between the two groups (risk ratio [RR]: 0.93, p = 0.07). Subgroup analyses indicated that dPDT was non-inferior to cPDT for CR in studies only included grade I-II AK lesions (RR: 0.97, p = 0.41), but less effective for CR in studies which also included grade III lesions (RR = 0.87, p 0.001). Subsequent meta-analyses showed that dPDT was associated with a significantly reduced maximal pain score (mean difference = -4.51, p 0.001) and a lower risk of adverse events (RR = 0.70, p 0.001) as compared with cPDT. These results suggested although dPDT was better tolerated, the treatment efficacy of dPDT is non-inferior to cPDT with red light and MAL only in grade I-II AK lesions. The relative therapeutic efficacy of dPDT in AK of grade III lesions in comparison with cPDT should be further evaluated.
机译：建议采用日光动力疗法（dPDT）对光化性角化病（AK）有效。我们对随机对照试验（RCT）进行了荟萃分析，以比较dPDT与传统光动力疗法（cPDT）在AK患者中的疗效和安全性。通过对PubMed，Embase和Cochrane图书馆进行系统搜索，确定了相关研究。根据异质性，应用固定或随机效应模型。纳入了369例有5556例AK病变的患者的6个RCT，这些患者正在接受dPDT或cPDT的红光和氨基乙酰丙酸甲酯（MAL）治疗。总体而言，两组的完全缓解（CR）发生率无显着差异（风险比[RR]：0.93，p = 0.07）。亚组分析表明，在仅包括I-II级AK病变的研究中，dPDT在CR方面不逊于cPDT（RR：0.97，p = 0.41），但在还包括III级病变的研究中，对CR的疗效较差（RR = 0.87） ，p <0.001）。随后的荟萃分析显示，与cPDT相比，dPDT与最大疼痛评分明显降低（平均差异= -4.51，p <0.001）和不良事件风险较低（RR = 0.70，p <0.001）相关。这些结果表明，尽管对dPDT的耐受性更好，但仅在I-II级AK病变中，dPDT的治疗效果不逊于红光和MAL的cPDT。与cPDT相比，dPDT在III级病变AK中的相对治疗效果应进一步评估。

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