Photodynamic therapy in the treatment of oral leukoplakia: A systematic review.

Highlights • First and comprehensive systematic review of photodynamic therapy in the treatment of oral leukoplakia. • Effectiveness and advantages of photodynamic therapy are indicated after statistical analysis. • Influencing factors of photodynamic therapy in oral leukoplakia are analyzed and recommended parameters are proposed. Abstract Objective The aim of the present study was to systematically review the efficacy of photodynamic therapy (PDT) in the management of oral leukoplakia (OLK). Methods This systematic review aimed to address the following focused question: "Is photodynamic therapy effective in the management of oral leukoplakia?" PubMed/Medline, EMBASE, ISI Web of Knowledge, OVID, CNKI, and WANFANG DATA were searched up to and including June 2018 using different combinations of the following keywords: photodynamic therapy, leukoplakia, oral dysplasia, oral precancers, and oral premalignant lesions. Results Sixteen studies were included in the present study. A total of 352 patients was included in this review, with age ranging from 20 to 79 years. Photosensitizers used were aminolevulinic acid, Photofrin, methylene blue, and chlorine-e6. Laser wavelength, duration of irradiation, and power density were 420–660 nm, 60–1000 s, and 100–150 mW/cm², respectively. On the whole, the rates of complete response and partial response were 32.9% and 43.2%, and the sum was 76.1%. The follow-up period ranged from 1 month to 119 months. The recurrence rate of OLK was 0–60%. Conclusion PDT appears to be a useful therapeutic strategy in the management of oral leukoplakia as a non-surgical treatment. Further RCTs with long follow-up period, standardized PDT parameters, and comparing efficacy of PDT with various other therapies are needed to acquire definite conclusions. [ABSTRACT FROM AUTHOR]