Conventional vs. daylight photodynamic therapy for patients with actinic keratosis on face and scalp: 12‐month follow‐up results of a randomized, intra‐individual comparative analysis

Abstract

Our study demonstrated that DLPDT is similar to CPDT in terms of long-term efficacy and recurrence rates in the treatment of face and scalp AKs. DLPDT demonstrated a better tolerability profile as it was associated with lower pain and less severe adverse events.

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

“…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.…”

“…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 .…”

“…In Sotiriou et al . 's study, DLPDT achieved a higher non‐complete response rate for grade I lesions and a lower complete‐response rate for grade II AKs when compared to CPDT; however, no significant difference was found between the two treatments . Our results concurred with the above finding that DLPDT has a similar complete‐response rate to CPDT.…”

“…Secondly, most of the comparisons showed significant heterogeneity, but we failed to perform further subgroup analysis to determine the potential sources of heterogeneity, owing to the lack of detailed information in the individual studies. Thirdly, the selected trials incorporated various design flaws, such as a lack of blinding in two of the studies; moreover, only one included study was double‐blinded. As in most cases, clinicians and patients could not be blinded to the treatment group, there was a potential for observer bias in determining outcomes.…”

“…Several previous studies have suggested that DLPDT is as effective as CPDT treatment using artificial light (light‐emitting diode [LED]‐PDT) . Moreover, DLPDT is also deemed to be less costly, less time‐consuming, less painful, and more tolerable to patients than CPDT treatment . A recent study published in 2015 demonstrated comparable efficacy of DLPDT and CPDT with grade I AKs (87% vs. 91%) but inferior efficacy of DLPDT with grade II AKs (61% for CPDT vs. 36% for DLPDT) .…”