ALA-mediated Photodynamic Therapy (ALA-PDT) is one of the most promising fields in Photodynamic therapy (PDT) research for cancer treatment. 5-aminolaevulinic acid (ALA) is the prodrug of the photosensitiser Protoporphyrin IX (PpIX). After ALA administration, cells generate PpIX through the haem biosynthetic pathway. Although the exact reasons for ALA/PpIX selectivity are unknown, it is believed that due to the special regulation of haem enzymes, PpIX is accumulated in the tumours.

Both ALA and its derivative ALA Methyl ester, are mainly used in dermatology. Besides, ALA-PDT has been employed for palliative and even curative treatment of endoscopically accessible tumours. Lung, oesophagus, gastric and bladder carcinomas, and also oral premalignant lesions, gynaecological intraepithelial neoplasias and Barrett's oesophagus are the conditions mostly treated with ALA-PDT. However, due to the limited penetration of ALA and light, non-dermatologic uses of ALA-PDT have not moved beyond phase I clinical trials.

On the other hand, ALA-induced PpIX fluorescence is successfully employed for the Photodynamic Diagnosis (PDD) or assistance in cytoreductive surgery (Fluorescence-guided Resection, FGR).

ALA has been approved for the FGR of high-grade gliomas and ALA Hexyl ester, for fluorescence cystoscopy in the diagnosis of bladder cancer. ALA-FGR is currently applied in brain, bladder, lung, colon cancers, etc. and ALA-PDD for oral premalignancies, gynaecological intraepithelial lesions and peritoneal metastases, among others. Besides, PDT can be applied concomitantly in the same diagnostic procedure.

This review aimed to analyse the state of the art of clinical uses of ALA in the areas of treatment and detection in the non-dermatologic oncology fields.

ALA介导的光动力疗法（ALA-PDT）是光动力疗法（PDT）研究癌症的最有前途的领域之一。5-氨基戊酸（ALA）是光敏剂原卟啉IX（PpIX）的前药。施用ALA后，细胞通过血红素生物合成途径生成PpIX。虽然尚不清楚ALA / PpIX选择性的确切原因，但据信由于血红素酶的特殊调节，PpIX会在肿瘤中积累。

ALA及其衍生物ALA甲酯均主要用于皮肤病学。此外，ALA-PDT已被用于内窥镜可及性肿瘤的姑息甚至治愈性治疗。肺癌，食道癌，胃癌和膀胱癌，以及口腔癌前病变，妇科上皮内瘤变和巴雷特食管是大多数用ALA-PDT治疗的疾病。但是，由于ALA和光的渗透性有限，ALA-PDT的非皮肤病学用途并未超出I期临床试验的范围。

另一方面，ALA诱导的PpIX荧光已成功用于光动力诊断（PDD）或辅助细胞还原手术（荧光引导切除术，FGR）。

ALA已被批准用于高级神经胶质瘤和ALA己基酯的FGR，用于荧光膀胱镜检查以诊断膀胱癌。ALA-FGR当前用于脑癌，膀胱癌，肺癌，结肠癌等，而ALA-PDD则用于口腔癌前病变，妇科上皮内病变和腹膜转移等。此外，PDT可以在同一诊断程序中同时使用。

这篇综述旨在分析ALA在非皮肤肿瘤学领域的治疗和检测领域中临床使用的最新技术水平。