Continuous ultra‐low‐intensity artificial daylight is not as effective as red <scp>LED</scp> light in photodynamic therapy of multiple actinic keratoses

Wiegell, Stine Regin; Heydenreich, Jakob; Fabricius, Susanne; Wulf, Hans Christian

doi:10.1111/j.1600-0781.2011.00611.x

Cited by 45 publications

(46 citation statements)

References 11 publications

(29 reference statements)

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“…The higher the score, the stronger the pain intensity. Pooled data across all eight studies, comprising 424 patients, revealed a lower level of pain in the patients who underwent DLPDT than in those who underwent CPDT ( n = 424; SMD, −2.544; 95% CI, −3.57 to −1.632; P < 0.001; Fig. ), suggesting a positive effect associated with DLPDT treatment of AKs with respect to pain.…”

Section: Resultsmentioning

confidence: 96%

“…Next, we read the entire texts of the remaining 22 studies in detail, of which 14 were discarded because they lacked the required outcome, contained duplicate data, or had not employed a test for randomness. Finally, eight articles comprising 424 patients were found to be suitable for this meta‐analysis and bias analysis . A flow diagram of our search strategy is shown in Figure .…”

Section: Resultsmentioning

confidence: 99%

“…All studies in this meta‐analysis were randomized controlled trials, and patients were randomly assigned to investigator‐blinded groups ( n = 3), single‐blinded groups ( n = 2), and a double‐blinded group ( n = 1) . Additionally, 354 patients from seven studies were treated with different intervention methods . In the selected studies, all patients were aged >60 years, and the majority were male.…”

Section: Resultsmentioning

confidence: 99%

“…In the selected studies, all patients were aged >60 years, and the majority were male. All eight studies included the follow‐up time, five studies included reports on the skin phototype (I/II/III), and three studies described the number of lesions treated (case/control) . Risk of bias in the results of each study was assessed by Cochrane Collaboration's tool, as shown in Figure .…”

Section: Resultsmentioning

confidence: 99%

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The safety and efficacy of daylight photodynamic therapy in the treatment of actinic keratoses: a systematic review and meta‐analysis

et al. 2018

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Daylight photodynamic therapy (DLPDT) is a novel therapeutic approach for actinic keratoses (AKs). This study aimed to evaluate the safety and efficacy of DLPDT in treating patients with AKs as compared to conventional photodynamic therapy (CPDT). PubMed, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials were searched for relevant randomized controlled trials (RCTs) published before November 2017, based on the following search terms: "solar keratoses", "actinic keratoses", "photodynamic therapy", "daylight photodynamic therapy", "conventional photodynamic therapy", and "randomized". The complete response rate, patient satisfaction, and patient-reported pain after intervention with DLPDT or CPDT were primarily measured. Sensitivity analysis was conducted to determine the reliability of results. Begg's and Egger's tests were used to assess the likelihood of publication bias. Eight RCTs, comprising a total of 424 patients with AKs treated with DLPDT or CPDT, were included. No significant difference was found between the lesion response rate and the mean lesion response in a comparison of DLPDT and CPDT treatments. Generally, DLPDT was associated with higher patient satisfaction than CPDT. The patients who underwent DLPDT experienced less pain than those who underwent CPDT. Most of our results were of high stability and low sensitivity. Meanwhile, no statistical evidence of publication bias among studies was found under all comparisons. In conclusion, DLPDT is a safe and effective therapy, which could help in selecting the most appropriate therapeutic method for treating AKs and in guiding physicians to optimize treatment strategies.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The safety and efficacy of daylight photodynamic therapy in the treatment of actinic keratoses: a systematic review and meta‐analysis

et al. 2018

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“…Even though this results in a slightly more shallow treatment due to the dominating absorbing features of PpIX in the blue wavelength range (figure 1 c) many efficient results have been reported. [5][6][7][8][9] Daylight has been shown to be associated with a lower experienced pain 10 and the preferred choice of treatment by the majority of patients. 3 In the work presented here we compare daylight PDT to conventional PDT where the artificial light source Aktilite is adopted (Akitlite, Photocure ASA, Norway 11 ).…”

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confidence: 99%

New insights into photodynamic therapy treatment through the use of 3D Monte Carlo radiation transfer modelling

Campbell

Wood

Brown

et al. 2016

Photonic Therapeutics and Diagnostics XII

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Photodynamic therapy (PDT) has been theoretically investigated using a Monte Carlo radiation transfer (MCRT) model. By including complex three dimensional (3D) tumour models a more appropriate representation of the treatment was achieved. The 3D clustered tumour model was compared to a smooth model, resulting in a significantly deeper penetration associated with the clustered model. The results from the work presented here indicates that light might penetrate deeper than suggested by 2D or simple layered models.

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Artificial White Light vs Daylight Photodynamic Therapy for Actinic Keratoses

et al. 2016

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IMPORTANCE Daylight photodynamic therapy using topical methyl 5-aminolevulinic acid (MAL) for actinic keratoses (AKs) is as effective as conventional photodynamic therapy but has the advantage of being almost pain free. Daylight photodynamic therapy, however, requires dry and warm weather conditions. OBJECTIVE To establish if topical MAL photodynamic therapy using a white light light-emitting diode (LED) lamp is as effective and well-tolerated as daylight photodynamic therapy for the treatment of AKs. DESIGN, SETTING, AND PARTICIPANTS Overall, 22 men with significant photodamage and a high number of AKs were enrolled in this prospective, randomized, single-blind study, employing a split-scalp design, comparing the effectiveness and adverse effects of daylight photodynamic therapy and artificial white light (AWL) LED photodynamic therapy for the treatment of AKs on the forehead and scalp. Organ transplant recipients were excluded. Patients were treated and evaluated at an academic tertiary referral dermatology center. Treatment lasted from April 2014 to July 2014 and follow-up visits occurred for 9 months posttreatment. INTERVENTIONS Two symmetrical treatment fields were defined and AKs counted, mapped, and photographed at baseline, 1, 3, 6, and 9 months. Patients had half of their scalp treated with daylight photodynamic therapy and the other half treated with AWL photodynamic therapy 1 week apart and randomly allocated. MAL was applied, and treatment commenced 30 minutes later and lasted 2 hours. Irradiance, illuminance, and light spectra measurements were performed. The integrated dose in J/cm 2 was measured. The effective light dose, weighted to the absorption spectrum for protoporphyrin IX, was calculated. MAIN OUTCOMES AND MEASURES The primary end point was the reduction in total AK count per treatment field. Secondary end points included adverse effects and patient satisfaction. RESULTS We enrolled 22 men with a median age of 72 years (range, 47-85 years) at baseline, the total (median of AKs per field) were 469 (20.5) for the DPDT group and 496 (20.5) for the AWLPDT group (P = .34). The median number and percentage of reduction in AKs per field were 12 and 62.3% for DPDT and 14 and 67.7% for AWLPDT at 1 month (P = .21 and P = .13, respectively). There was no significant difference in the reduction percentage of AKs for either treatment at 1, 3, and 6 months. At 9 months, the median number and percentage of reduction in AKs per field was 9.0 and 48.4% for DPDT and 12.0 and 64.4% for AWLPDT (P = .13 and P = .05, respectively). Pain was reported by 14 patients with DPDT and 16 patients with AWLPDT (median maximum score [out of 100], 4 vs 6; P = .51). Moderate erythema was reported by 9 patients after DPDT and 14 patients after AWLPDT. On a scale of 0 (intolerable) to 10 (very tolerable) patients rated DPDT as 9.5 and AWLPDT as 9 (P = .37). CONCLUSIONS AND RELEVANCE Photodynamic therapy using an AWL source was as effective and well-tolerated as daylight photodynamic therapy. TRIAL REGISTRATION clinicaltrials.g...

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Continuous ultra‐low‐intensity artificial daylight is not as effective as red LED light in photodynamic therapy of multiple actinic keratoses

Abstract: Even very low-intensity/dose artificial daylight-mediated PDT of multiple AKs resulted in a response rate of more than 50%. However, to ensure efficacies equivalent to conventional LED-PDT, the treatment should not be conducted on very overcast days.

Cited by 45 publications

References 11 publications

The safety and efficacy of daylight photodynamic therapy in the treatment of actinic keratoses: a systematic review and meta‐analysis

The safety and efficacy of daylight photodynamic therapy in the treatment of actinic keratoses: a systematic review and meta‐analysis

New insights into photodynamic therapy treatment through the use of 3D Monte Carlo radiation transfer modelling

Artificial White Light vs Daylight Photodynamic Therapy for Actinic Keratoses

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