Efficacy and safety of photodynamic therapy for port-wine stains: a meta analysis
10.3760/cma.j.issn.1671-0290.2024.05.014
- VernacularTitle:光动力疗法治疗鲜红斑痣疗效和安全性的Meta分析
- Author:
Hong MA
1
;
Yumei LI
Author Information
1. 江苏大学附属医院皮肤科，镇江 212001
- Keywords:
Port-wine stain;
Photodynamic therapy;
Pulsed dye laser;
Efficacy;
Safety
- From:
Chinese Journal of Medical Aesthetics and Cosmetology
2024;30(5):480-487
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically evaluate the efficacy and safety of photodynamic therapy (PDT) in the treatment of port-wine stains (PWS).Methods:PubMed, Cochrane Library, CNKI, Wanfang database were electronically searched to collect randomized controlled trials (RCTs) of PDT for PWS and data was analyzed using RevMan 5.4 provided by Cochrane Collaboration from March 2022 to March 2023 in the Department of Dermatology, Affiliated Hospital of Jiangsu University.Results:A total of 9 studies involving 1 190 patients were included. Two studies compared PDT with placebo, the total efficiency rate of PDT was increased ( OR=24.81, 95% CI: 14.68-41.93, P<0.01). Four studies compared PDT with laser [pulsed dye laser (PDL), CO 2 laser] and showed that PDT had a higher therapeutic efficiency ( OR=3.43, 95% CI: 1.79-6.58, P<0.01). The efficiency rate of PDT was lower than PDT + PDL in two studies ( OR=0.19, 95% CI: 0.08-0.45, P<0.01). The treatment reaction of PDT group was higher than that of placebo group, especially pain, burning, pruritus, swelling and scab ( OR=49.99, 95% CI: 23.95-104.35, P<0.01; OR=5.22, 95% CI: 3.40-8.02, P<0.01; OR=8.68, 95% CI : 4.75-15.87, P<0.01; OR=62.04, 95% CI: 23.92-160.9, P<0.01; OR=203.14, 95% CI: 28.91-1427.34, P<0.01), the incidence of blister was not higher than that of placebo group ( OR=2.62, 95% CI: 0.88-7.85, P=0.08). Compared with placebo, long-term adverse reactions were increased, especially hyperpigmentation ( OR=65.62, 95% CI: 4.06-1061.30, P<0.01). Both PDT and PDL showed treatment response, but the most common long-term adverse reaction hyperpigmentation did not increase ( OR=1.04, 95% CI: 0.59-1.82, P=0.89). There was no significant difference in the incidence of long-term adverse reaction hyperpigmentation between PDT and PDT+ PDL groups ( OR=1.69, 95% CI: 0.40-7.23, P=0.48). Conclusions:PDT is effective in the treatment of PWS, and has a better effect than the current treatment. Although the treatment reaction is higher, the most common long-term adverse reaction hyperpigmentation does not increase, and PDT combined with PDL is a new direction to improve the efficiency rate.
