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首页> 外文期刊>Photodiagnosis and Photodynamic Therapy >Sequential daylight photodynamic therapy and ingenol mebutate versus 2 sessions of daylight photodynamic therapy for the treatment of actinic keratosis: An observational, prospective, comparative study
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Sequential daylight photodynamic therapy and ingenol mebutate versus 2 sessions of daylight photodynamic therapy for the treatment of actinic keratosis: An observational, prospective, comparative study

机译：连续日光光动力疗法和甲磺酸丁香酚与2疗程日光光动力疗法治疗光化性角化病的比较：一项观察性，前瞻性，比较研究

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Background.- Field-directed therapy, such as daylight-photodynamic therapy (DL-PDT) or ingenol mebutate (IM), is indicated for multiple actinic keratosis (AK) lesions located on contiguous areas of skin with significant sun damage.Objective: To compare the efficacy of sequential DL-PDT and IM treatment with that of 2 sessions of DL-PDT in AK patients.Material and methods: For this observational, multicenter, prospective study we recruited patients for whom DL-PDT was indicated for the treatment of AK lesions (grades I and II) located on the head. After 1 month of followup those who did not achieve a satisfactory clinical response received either a second session of DL-PDT or were treated with IM. Epidemiological and clinical data were collected and analyzed.Results: Forty-three patients were enrolled (39 male, 4 female). The mean (standard deviation, SD) age was 78 (7.84) years, and the mean (SD) number of AK lesions per patient was 9.58 (1.16). After the first session of DL-PDT, 27 patients (62.8%) required further treatment: 13 (48.1%) received a second session of DL-PDT and 14 (51.9%) were treated with IM. After 1 year of follow-up, lesion clearance rates were higher in patients who received 2 sessions of DL-PDT than those treated with sequential DL-PDT plus IM (75.2%vs 54.6%, p = 0.0013). Local skin reactions were more frequent in the DL-PDT plus IM group than the group treated with 2 sessions of DL-PDT (p = 0.0245).Conclusions: The combination of DL-PDT plus IM appears to have no synergistic effect in the treatment of field cancerization, and offers no benefits over 2 sessions of DL-PDT monotherapy, although both combinations produced high lesion clearance rates, a good safety profile, excellent cosmetic outcome, and good patient satisfaction.
机译：背景-定向治疗，例如日光动力疗法（DL-PDT）或丁香酚丁香酸酯（IM），适用于位于皮肤连续区域且日光严重损害的多发性光化性角化病（AK）病变。比较连续DL-PDT和IM治疗与AK患者2次DL-PDT的疗效。材料和方法：对于这项观察性，多中心，前瞻性研究，我们招募了接受DL-PDT治疗的AKT患者。 AK病变（I级和II级）位于头部。随访1个月后，那些未取得满意临床反应的患者接受了第二次DL-PDT治疗或接受了IM治疗。结果：43例患者中男39例，女4例。平均（标准差，SD）年龄为78（7.84）岁，每位患者AK病变的平均（SD）数量为9.58（1.16）。第一次DL-PDT治疗后，有27名患者（62.8％）需要进一步治疗：13例（48.1％）接受了第二次DL-PDT治疗，其中14例（51.9％）接受了IM治疗。随访1年后，接受2次DL-PDT治疗的患者的病灶清除率高于连续DL-PDT加IM治疗的患者（75.2％vs 54.6％，p = 0.0013）。 DL-PDT + IM组的局部皮肤反应比经2次DL-PDT治疗的组更频繁（p = 0.0245）。结论：DL-PDT + IM的组合在治疗中似乎没有协同作用。尽管这两种组合均可产生较高的病灶清除率，良好的安全性，出色的美容效果和良好的患者满意度，但仍可避免2次DL-PDT单药治疗的益处。

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