Effects Of Topical Photodynamic Therapy Research Articles

Therapeutic effects of topical photodynamic therapy with 5-aminolevulinic acid on cervical high-grade squamous intraepithelial lesions

BackgroundTopical photodynamic therapy with 5-aminolevulinic acid (ALA-PDT) is a non-invasive option for treatment of Cervical Intraepithelial Neoplasia (CIN). We investigated the clinical efficacy and safety of ALA-PDT in treatment of patients with cervical high-grade squamous intraepithelial lesion (HSIL) and evaluated the factors that effect the efficacy of PDT. MethodsA total of 99 patients (average age: 30 years (18–45 years old)) with cervical HSIL and high-risk Human Papilloma Virus (hr-HPV) infections and who had received ALA-PDT were enrolled in this retrospective study. Before ALA-PDT, cervical exfoliated cells from all patients were obtained for HPV genotyping, liquid-based cytology test (LBC) and PAX1 methylation (PAX1m) test. Then, 6 months after ALA-PDT, HPV genotyping, LBC and colposcopy-directed biopsy were conducted. During subsequent follow-up, HPV genotyping and LBC were performed, and colposcopy-directed biopsy was conducted if hr-HPV was positive and/or LBC result was abnormal. ResultsAt 6 months after treatment, total HPV clearance and lesions complete remission (CR) rates were 64.6% (64/99) and 88.9% (88/99), while at 1-year of follow-up, they were 81.3% (65/80) and 92.5% (74/80), respectively. At 1-year follow-up, HPV clearance rate was higher, relative to 6 months after ALA-PDT (p <0.05). At 6 months after treatment, HPV clearance and CR rates in the PAX1 hypermethylation (PAX1hm) group were 36.8% and 73.7%, which were lower compared to the rates for PAX1 hypomethylation (PAX1lm) group (71.3%, 92.5%) (p <0.05). Moreover, of the 11 patients with cervical canal lesions, 3 (3/7, 42.9%) patients had cervical canal HSIL persistence and the other 4 cervical canal HSIL and all of the 4 cervical canal LSIL had complete remission. ConclusionsALA-PDT is an effective, safe treatment approach for patients with cervical HSIL and hr-HPV infections. Patients with PAX1lm showed better therapeutic outcomes than patients with PAX1hm or cervical canal HSIL.

Long Term Effectiveness of Photodynamic Therapy for CIN Treatment.

(1) Background: Cervical cancer is the third most commonly diagnosed cancer and the fourth leading cause of cancer death in women worldwide. The highest incidence rates are in Africa, followed by South-Central Asia and South America. According to the Brazilian National Institute of Cancer (INCA), 16,370 new cases of cervical cancer were estimated for each year of the biennium of 2018–2019. About 90% of cervical cancers originate from the malignant progression of cervical intraepithelial neoplasia (CIN) which is classified based on cytohistological characteristics (low- and high-grade lesions). The present study reports the long-term effectiveness of topical photodynamic therapy (PDT) for CIN grades 1 and 2/3 with up to two years of follow up. (2) Methods: A total of 56 patients with CIN 1, ten with CIN 2, and 14 patients for the placebo group were enrolled in this study. (3) Results: 75% (n = 42) of CIN 1 patients presented a complete response to PDT and only 23.2% (n = 13) of recurrence, progression, and/or lesions remaining two years after PDT. For CIN 2/3 patients, 90% were observed to be cured after one and two years of follow up. (4) Conclusions: PDT presented best results two years after a non-invasive, fast, and low-cost procedure and in comparison with the placebo group, preventing the progression of cervical intraepithelial neoplasia and preserving the cervix.

Adverse effects of topical photodynamic therapy: a consensus review and approach to management.

Topical photodynamic therapy (PDT) is widely used to treat superficial nonmelanoma skin cancer and dysplasia, and is generally well tolerated. However, as with all treatments, adverse effects may occur and awareness may facilitate approaches to prevention and management. To review the available evidence relating to the adverse effects of topical PDT, to help inform recommendations in updated clinical guidelines produced by the British Association of Dermatologists and British Photodermatology Group, and the efficacy of preventative and therapeutic approaches. This review summarizes the published evidence related to the adverse effects of topical PDT and attempts to interpret this evidence in the context of patient risk and management. Pain and discomfort during PDT are acute adverse effects, which can be minimized through the use of modified and low-irradiance PDT regimens and do not therefore usually limit successful treatment delivery. Other adverse effects include the risk of contact allergy to photosensitizer prodrugs, although this is rare but should be kept in mind, particularly for patients who have received multiple PDT treatments to larger areas. There are no other significant documented longer-term risks and, to date, no evidence of cumulative toxicity or photocarcinogenic risk. Topical PDT is usually well tolerated, reinforcing the utility of this important therapeutic option in dermatology practice. The main acute adverse effect of pain can typically be minimized through preventative approaches of modified PDT regimens. Other adverse effects are uncommon and generally do not limit treatment delivery.

Topical photodynamic therapy in the treatment of basal cell carcinoma in Singaporean Chinese patients.

Topical photodynamic therapy has been used for the treatment of superficial and nodular basal cell carcinomas, with varying cure rates. This study aims to evaluate the effectiveness of topical photodynamic therapy in the treatment of superficial and nodular basal cell carcinomas in Asian patients treated at the National Skin Centre, Singapore. A retrospective analysis of Asian patients with histologically confirmed basal cell carcinomas and treated with photodynamic therapy was performed. Eight Chinese patients, with an equal gender distribution and mean age of 83.4 years were included. Five of eight basal cell carcinomas were superficial while the remaining three were nodular. The basal cell carcinomas were located in the head and neck in seven patients. The overall clearance rate at 3 months was 87.5% while the clearance rate for superficial and nodular basal cell carcinomas was 100% and 66.6% respectively at 3 months. At 12 months, the overall clearance rate was 85. 7%. This is a retrospective analysis with small patient numbers. In this small series of eight Asian patients, topical photodynamic therapy has been shown to be effective and generally well-tolerated in the treatment of basal cell carcinomas, particularly of the superficial subtype. However, larger studies are needed to evaluate its overall efficacy in Asian patients.

Nicotinamide reduces photodynamic therapy-induced immunosuppression in humans

The immune suppressive effects of topical photodynamic therapy (PDT) are potential contributors to treatment failure after PDT for nonmelanoma skin cancer. Nicotinamide (vitamin B(3) ) prevents immune suppression by ultraviolet radiation, but its effects on PDT-induced immunosuppression are unknown. To determine the effects of topical and oral nicotinamide on PDT-induced immunosuppression in humans. Twenty healthy Mantoux-positive volunteers received 5% nicotinamide lotion or vehicle to either side of the back daily for 3 days. Another group of 30 volunteers received 500 mg oral nicotinamide or placebo twice daily for 1 week in a randomized, double-blinded, crossover design. In each study, methylaminolaevulinate cream was applied to discrete areas on the back, followed by narrowband red light irradiation (37 J cm(-2) ) delivered at high (75 mW cm(-2) ) or low (15 mW cm(-2) ) irradiance rates. Adjacent, nonirradiated sites served as controls. Delayed-type hypersensitivity (Mantoux) reactions were assessed at treatment and control sites to determine immunosuppression. High irradiance rate PDT with vehicle or with placebo caused significant immunosuppression (equivalent to 48% and 50% immunosuppression, respectively; both P < 0·0001); topical and oral nicotinamide reduced this immunosuppression by 59% and 66%, respectively (both P < 0·0001). Low irradiance rate PDT was not significantly immunosuppressive in the topical nicotinamide study (15% immunosuppression, not significant), but caused 22% immunosuppression in the oral study (placebo arm; P = 0·006); nicotinamide reduced this immunosuppression by 69% (P = 0·045). While the clinical relevance of these findings is currently unknown, nicotinamide may provide an inexpensive means of preventing PDT-induced immune suppression and enhancing PDT cure rates.

Adverse effects of topical photodynamic therapy

Topical photodynamic therapy (PDT) is increasingly used in dermatology, particularly for the treatment of superficial non-melanoma skin cancer and dysplasia. Treatment is generally considered to be well tolerated, although pain during PDT can be a limiting factor. This review explores the adverse effects of topical PDT. A thorough search of the literature using Medline was undertaken and published data were evaluated and presented in conjunction with our own experience. Pain during PDT is the most commonly reported adverse effect and may prevent successful treatment delivery, although low-irradiance regimes and use of nerve blocks or cooling air can be used to reduce pain. Other acute and chronic adverse effects are reported but do not seem to be limiting factors in the use of topical PDT. To date, there is no convincing evidence for a carcinogenic effect of this treatment. Topical PDT is associated with few significant adverse effects, although methods to optimize regimes and minimize pain are required to improve the acceptability of this therapy for patients.

Aesthetic effects of topical photodynamic therapy

Topical photodynamic therapy has shown to be effective for the treatment of several aspects of skin ageing. Multiple studies have demonstrated improvement of fine wrinkles, mottled hyperpigmentation, tactile roughness and sallowness. These results are supported by immunohistochemical analysis that revealed both upregulation of collagen production and increased epidermal proliferation. Neocollagenesis as an indirect dermal effect of photodynamic therapy is stimulated through cytokine induction. This article reviews the available literature for photodynamic rejuvenation while discussing cosmetic effects, light sources, adverse effects and the mechanism of action.

Does ambient light contribute to the therapeutic effects of topical photodynamic therapy (PDT) using aminolevulinic acid HCl (ALA)?

Lasers in Surgery and MedicineVolume 39, Issue 3 p. 201-202 Letter to the Editor Does ambient light contribute to the therapeutic effects of topical photodynamic therapy (PDT) using aminolevulinic acid HCl (ALA)?† Stuart L. Marcus MD, PhD, Corresponding Author Stuart L. Marcus MD, PhD [email protected] Department of Medical Affairs, DUSA Pharmaceuticals, Inc., Valhalla, New York 10595400 Columbus Avenue, Valhalla, NY 10595.Search for more papers by this authorAnna Houlihan MA, Anna Houlihan MA Department of Medical Affairs, DUSA Pharmaceuticals, Inc., Valhalla, New York 10595Search for more papers by this authorScott Lundahl, Scott Lundahl Department of Medical Affairs, DUSA Pharmaceuticals, Inc., Valhalla, New York 10595Search for more papers by this authorMary E. Ferdon PhD, Mary E. Ferdon PhD Therapeutics, Inc., San Diego, CaliforniaSearch for more papers by this author Stuart L. Marcus MD, PhD, Corresponding Author Stuart L. Marcus MD, PhD [email protected] Department of Medical Affairs, DUSA Pharmaceuticals, Inc., Valhalla, New York 10595400 Columbus Avenue, Valhalla, NY 10595.Search for more papers by this authorAnna Houlihan MA, Anna Houlihan MA Department of Medical Affairs, DUSA Pharmaceuticals, Inc., Valhalla, New York 10595Search for more papers by this authorScott Lundahl, Scott Lundahl Department of Medical Affairs, DUSA Pharmaceuticals, Inc., Valhalla, New York 10595Search for more papers by this authorMary E. Ferdon PhD, Mary E. Ferdon PhD Therapeutics, Inc., San Diego, CaliforniaSearch for more papers by this author First published: 24 January 2007 https://doi.org/10.1002/lsm.20460Citations: 8 † All authors have disclosed potential conflicts of interest with this study. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume39, Issue3March 2007Pages 201-202 RelatedInformation

Photodynamic therapy of superficial basal cell carcinomas using exogenous 5‐aminolevulinic acid and 514‐nm light

AbstractObjective The evaluation of the effectiveness of topical photodynamic therapy with 5‐aminolevulinic acid (5‐ALA) and green laser light on superficial basal cell carcinomas.Background Topical photodynamic therapy with exogenous 5‐ALA and visible or red laser light has been used up to now for the treatment of superficial non‐melanoma skin tumors.Patients and methods Four patients with nine superficial carcinomas participated in this study. The tumors were irradiated with green laser light 5 h after the application of cold cream with 20% aminolevulinic acid under occlusive dressing.Results All nine lesions were resolved with a single treatment and clinical evidence of recurrence was observed in one tumor 1 year after the therapy.Conclusion Topical photodynamic therapy with exogenous 5‐ALA and green laser light is very effective for superficial basal cell carcinomas.

Photodynamic therapy of superficial basal cell carcinomas using exogenous 5-aminolevulinic acid and 514-nm light

Objective The evaluation of the effectiveness of topical photodynamic therapy with 5-aminolevulinic acid (5-ALA) and green laser light on superficial basal cell carcinomas.Background Topical photodynamic therapy with exogenous 5-ALA and visible or red laser light has been used up to now for the treatment of superficial non-melanoma skin tumors.Patients and methods Four patients with nine superficial carcinomas participated in this study. The tumors were irradiated with green laser light 5 h after the application of cold cream with 20% aminolevulinic acid under occlusive dressing.Results All nine lesions were resolved with a single treatment and clinical evidence of recurrence was observed in one tumor 1 year after the therapy.Conclusion Topical photodynamic therapy with exogenous 5-ALA and green laser light is very effective for superficial basal cell carcinomas.