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Ablative fractional laser–assisted photodynamic therapy provides superior long-term efficacy compared with standard methyl aminolevulinate photodynamic therapy for lower extremity Bowen disease
Journal of the American Academy of Dermatology ( IF 13.8 ) Pub Date : 2018-05-29 , DOI: 10.1016/j.jaad.2018.05.034
Ho-Jin Kim , Ki-Hoon Song

Background

Ablative fractional laser (AFL)-assisted methyl aminolevulinate (MAL) photodynamic therapy (PDT) (AFL-MAL-PDT) has shown significantly higher efficacy and lower recurrence rates at 12 months than conventional methyl aminolevulinate photodynamic therapy (MAL-PDT) for the treatment of Bowen disease (BD). However, long-term follow-up data are not available.

Objective

To compare the 5-year efficacy and recurrence rates of AFL-MAL-PDT with those of conventional MAL-PDT for the treatment of lower extremity BD.

Methods

A total of 60 patients with 84 BD lesions were randomly assigned to a single session of AFL-MAL-PDT or 2 sessions of MAL-PDT with a 1-week interval between sessions. Patients were followed up at 3, 12, 24, 36, 48, and 60 months after treatment. Efficacy, recurrence rates, and risk factors for unsuccessful treatments were assessed.

Results

After 5 years, the overall clearance rate of AFL-MAL-PDT (84.78%) was significantly better than that of MAL-PDT (44.74%) for BD lesions. The recurrence rate was significantly lower for AFL-MAL-PDT (9.3%) than for MAL-PDT (41.38%). Diameters larger than 20 mm and lesions with a history of previous treatment were independent factors for treatment failure.

Limitations

The small sample size and single-center study design were limitations.

Conclusions

For patients with lower extremity BD lesions, AFL-MAL-PDT showed significantly higher long-term efficacy and lower recurrence rates than standard MAL-PDT.



中文翻译:

与标准氨基乙酰丙酸甲酯光动力疗法相比,烧蚀性激光辅助光动力疗法具有更好的长期疗效,可用于下肢博恩病

背景

消融分数激光(AFL)辅助的氨基乙酰丙酸甲酯(MAL)光动力疗法(PDT)(AFL-MAL-PDT)在12个月时显示出比传统的氨基乙酰丙酸甲酯光动力疗法(MAL-PDT)显着更高的疗效和更低的复发率。博文病(BD)的治疗。但是,没有长期的随访数据。

客观的

为了比较AFL-MAL-PDT与传统MAL-PDT治疗下肢BD的5年疗效和复发率。

方法

总共60例具有84个BD病变的患者被随机分配到AFL-MAL-PDT的单个疗程或MAL-PDT的2个疗程,每个疗程之间间隔1周。在治疗后3、12、24、36、48和60个月对患者进行随访。评估疗效,复发率和治疗失败的危险因素。

结果

5年后,BD病变的AFL-MAL-PDT总清除率(84.78%)明显优于MAL-PDT(44.74%)。AFL-MAL-PDT的复发率(9.3%)明显低于MAL-PDT(41.38%)。直径大于20 mm以及有既往治疗史的病变是治疗失败的独立因素。

局限性

小样本量和单中心研究设计是局限性。

结论

对于下肢BD病变的患者,AFL-MAL-PDT与标准MAL-PDT相比,具有更高的长期疗效和更低的复发率。

更新日期:2018-05-29
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