Association between photodynamic diagnosis and treatment efficacy of 5-aminolevulinic acid photodynamic therapy for cutaneous squamous cell carcinoma in situ
10.13406/j.cnki.cyxb.003889
- VernacularTitle:光动力荧光诊断与皮肤原位鳞状细胞癌5-氨基酮戊酸光动力治疗疗效的相关性研究
- Author:
Qinyuan ZHU
1
;
Wenjuan MA
;
Jing LUAN
;
Wenyu WU
;
Shujun CHEN
Author Information
1. 复旦大学附属华山医院皮肤科,上海 200040
- Keywords:
photodynamic diagnosis;
photodynamic therapy;
cutaneous squamous cell carcinoma in situ;
5-aminolevulinic acid;
fluo-rescence intensity;
treatment efficacy
- From:
Journal of Chongqing Medical University
2025;50(8):1115-1121
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the association between photodynamic diagnosis(PDD)and treatment efficacy of 5-aminolevu-linic acid(ALA)photodynamic therapy(PDT)in patients with cutaneous squamous cell carcinoma in situ(cSCCis).Methods:A pro-spective cohort study was conducted among the patients with cSCCis who underwent ALA-PDT in Department of Dermatology,Huashan Hospital,Fudan University,from January 2020 to November 2024.All patients were diagnosed with cSCCis based on biopsy,and invasive squamous cell carcinoma was excluded.Clinical information was collected and PDD was performed before treatment,and the patients were divided into moderate fluorescence group and strong fluorescence groups based on fluorescence intensity.All patients received six sessions of PDT treatment at an interval of 1-2 weeks.The primary endpoint was the initial complete clearance rate at 3 months after the last treatment session,and secondary endpoints were the sustained complete clearance rate at 12 months after the last treatment session and treatment failure rate.The multivariate regression analysis,the survival curves,and the Cox regression analysis were used to investigate the association between PDD fluorescence intensity and treatment efficacy,as well as other influencing factors for treatment efficacy.Results:Compared with the strong fluorescence group,the moderate fluorescence group had significantly lower initial complete clearance rate[57.14%(8/14)vs.93.33%(28/30),odds ratio OR=0.100,P=0.010]and sustained complete clearance rate[42.86%(6/14)vs.76.67%(23/30),OR=0.230,P=0.030)].The multivariate regression analysis showed that moderate fluores-cence was an independent risk factor for initial complete clearance(OR=0.030,P=0.030).The moderate fluorescence group had a significantly higher treatment failure rate than the strong fluorescence group[57.14%(8/14)vs.23.33%(7/30),P=0.030].The survival analysis and the Cox regression analysis showed that moderate fluo-rescence was an independent risk factor for PDT treatment failure(hazard ratio=3.040,P=0.048).There were no significant differences in adverse reactions between the two groups.Conclusion:PDD fluorescence intensity can predict the efficacy of ALA-PDT in patients with cSCCis.Moderate fluorescence indicates a higher risk of treatment failure,which can help to guide clinicians in develop-ing individualized treatment strategies.
