Source:Photodiagnosis and Photodynamic Therapy
Author(s): Jingwen Xue, Cynthia Liu, Yuehua Liu
Mycosis fungoides is the most common cutaneous T-cell lymphoma. It is characterized by slow progress over years to decades, developing from patches to infiltrated plaques, and sometimes to tumors. Therapies such as localized chemotherapy, photochemotherapy and radiotherapy are often employed when lesions of refractory or relapsing mycosis fungoides are resistant to conventional therapies. However, these methods have acute or chronic side effects and toxicity, which may accumulate with repeated and protracted treatment cycles. Photodynamic therapy is a promising, well-tolerated option for the treatment of localized lesions with excellent cosmetic outcomes. In this article, we systematically reviewed and discussed clinical application of photodynamic therapy in relapsed or refractory mycosis fungoides. There are 20 papers included in this review article.
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Wenbo Bu, Mengli Zhang, Qian Zhang, Chunyu Yuan, Xu Chen, Fang Fang
Some basal cell carcinomas (BCCs) are indistinguishable from nevi based on clinical manifestations. Therefore, it is often difficult for the excision margins of the initial surgical treatment to achieve radical removal of the malignancy. This study was a comparative analysis of the clinical results of aminolevulinic acid (ALA)-photodynamic therapy (PDT) or secondary surgery after the primary excision. In total, 20 patients with preoperative clinical diagnoses of nevi underwent in situ resection. The postoperative pathological diagnoses confirmed all cases were BCC. Ten patients received PDT twice after the primary excision, and 10 cases received extended resection after the primary excision. Patients were followed up for 8 months at least, and the 2 groups did not show statistically significant differences in the recurrence rate, while the PDT group had better results in terms of economic burden, healing period, and cosmetic satisfaction than the group with secondary surgery. Our study demonstrates that ALA-PDT can sever as a considerable remedial treatment for the BCC patients who have not accepted radical resection due to primary clinical misdiagnosis.
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Tariq Abduljabbar, Fahim Vohra, Fawad Javed, Zohaib Akram
BackgroundTo determine whether treatment with antimicrobial photodynamic therapy (aPDT) as an adjunct to scaling and root planing (SRP) improves periodontal clinical and glycemic outcomes in chronic periodontitis patients (CP) with type 2 diabetes mellitus (DM).MethodsDatabases (MEDLINE via PubMed; EMBASE; Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) were searched up to and including October 2016. The addressed PICO question was: “What are the effects aPDT as an adjunct to SRP in terms of periodontal and glycemic outcomes as compared to SRP alone in individuals with DM?”ResultsFour randomized clinical trials were included in the present review. All studies reporting clinical periodontal and metabolic parameters, showed that aPDT was effective in the treatment of CP in DM subjects at follow up. Considering the effects of aPDT as an adjunct as compared to SRP alone on clinical signs of CP in DM subjects, no difference could be observed for all evaluated parameters (PD: Z=−0.61, P=0.54; CAL: Z=0.27, P=0.78; HbA1c: Z=0.138, P=0.89)ConclusionIt remains debatable whether aPDT is effective as an adjunct to SRP than SRP alone in patients having CP with DM, given that the scientific evidence is weak. In terms of periodontal parameters and glycemic levels, aPDT does not provide additional benefit in the treatment of CP in DM patients. However, further randomized clinical trials with standard laser parameters and long follow up periods are warranted to study periodontal and glycemic outcomes in this regard.
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Dong Xue, Ying Zhao
PurposeTo evaluate the clinical efficacy of antimicrobial photodynamic therapy (aPDT) adjunctive to scaling and root planing (SRP) in the treatment of residual pockets for chronic periodontitis patients on supportive periodontal therapy (SPT).MethodBibliographic databases of MEDLINE and Cochrane Library were thoroughly searched up to July 2016 for eligible randomized controlled trials (RCTs). Mean differences (MD) and the corresponding 95% confidence intervals (CI) were synthesized for probing depth (PD) reduction and clinical attachment level (CAL) gain. The I2 test and Q statistics were employed to assess inter-study heterogeneity. Subgroup analysis was performed based on the enrollment of smokers.ResultFour RCTs fulfilling the eligibility criteria were included. Pooled estimates demonstrated statistically significant improvements in both PD reduction (MD=0.69, CI: 0.11–1.28, p=0.02) and CAL gain (MD=0.60, CI: 0.11–1.10, p=0.02) for SRP+aPDT versus SRP alone. Meta-analysis of studies with smokers failed to produce a significant additional effect in PD (MD=0.32, CI: −0.30 to 0.94, p=0.31) and CAL (MD=0.42, CI: −0.26 to 1.09, p=0.23) when SRP was associated with aPDT. However, significant enhancements in PD reduction (MD=1.23, CI: 0.74–1.72, p<0.001) and CAL gain (MD=0.96, CI: 0.31–1.62, p=0.004) were observed for studies excluding smokers.ConclusionPooled evidence indicates an additional clinical improvement in the maintenance of residual pockets in favor of SRP+aPDT compared with SRP alone. Subgroup analysis demonstrates an adverse impact of smoking on clinical effect of the combined therapy. Substantial heterogeneity and the paucity of included studies undermine the statistical power of this meta-analysis. Future well-designed and large-scale clinical trials evaluating the adjunctive efficacy of aPDT in periodontal maintenance phase are critically needed.
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