Laser-assisted photodynamic therapy for actinic keratosis: A systematic review and meta-analysis

Photodynamic therapy (PDT) is an effective intervention for actinic keratosis and field cancerization. Ablative fractional lasers may facilitate the delivery of photosensitizers and thereby improve the effects of PDT. To summarize the current evidence on the efficacy and safety of laser-assisted PDT...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2019-04, Vol.80 (4), p.947-956
Main Authors: Steeb, Theresa, Schlager, Justin Gabriel, Kohl, Christoph, Ruzicka, Thomas, Heppt, Markus V., Berking, Carola
Format: Article
Language:English
Subjects:
actinic keratosis
carbon dioxide laser
erbium:yttrium-argon-garnet laser
general oncology
meta-analysis
photodynamic therapy
senile keratosis
solar keratosis
systematic review
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Summary:Photodynamic therapy (PDT) is an effective intervention for actinic keratosis and field cancerization. Ablative fractional lasers may facilitate the delivery of photosensitizers and thereby improve the effects of PDT. To summarize the current evidence on the efficacy and safety of laser-assisted PDT. We performed a systematic literature research in Medline, Embase, and the Cochrane Central Register of Controlled Trials and hand-searched pertinent trial registers for eligible randomized controlled trials. Results from individual studies were pooled by using a random-effects model. The risk of bias was estimated with the Cochrane Risk of Bias Tool, and the quality of evidence of the outcomes was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation approach. Of 817 records initially identified, 7 randomized controlled trials were included in the qualitative analysis and 4 were included in the meta-analysis. Laser-assisted PDT showed significantly higher clearance rates than did PDT monotherapy (risk ratio, 1.33; 95% confidence interval, 1.24-1.42; I2 = 25%; P 
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2018.09.021