.png){kind=icon}
.png){kind=icon}
Return
Comparative Efficacy of Photodynamic Therapy Versus Cryotherapy for Actinic Keratosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
.png){kind=icon}
PRE
AI
A
A
A
T
K
A
A
M
A
DOI：10.1111/jocd.70749.png)
.png){kind=icon}
Original request for help.png){kind=icon}
Share.png){kind=icon}
Save
Abstract
En 中文
Background Photodynamic therapy and cryotherapy are treatment options for actinic keratosis; however, their efficacy and safety remain debated. Aims To perform a high-quality systematic review and meta-analysis exploring the efficacy and safety of photodynamic therapy and cryotherapy in actinic keratosis. Methods A systematic search was performed applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched PubMed, Web of Science, Cochrane, Science Direct, Ovid, EBSCO, Wiley, and Google Scholar for randomized controlled trials. Results A total of seven studies with 1233 patients were identified. PDT and cryotherapy showed similar success in clearing lesions (RR, 1.02; 95% CI, 0.92-1.13; p = 0.74). While both treatments performed comparably on the head and face (RR, 1.10; 95% CI, 0.94-1.28; p = 0.24), data from one trial suggested cryotherapy might be more effective for lesions on the arms and legs (RR, 0.88; 95% CI, 0.82-0.94; p < 0.05). However, more research is needed to confirm this finding. Cosmetic outcomes were significantly better for PDT (74.62% vs. 49.11%: RR, 1.52; 95% CI, 1.4-1.65; p < 0.00001) than cryotherapy. Similarly, PDT was superior to cryotherapy in patient satisfaction though the overall difference was not statistically significant (RR, 1.43; 95% CI, 0.91-2.25; p = 0.12). PDT was associated with a significantly higher risk of burning sensations and pain (RR, 1.95; 95% CI, 1.27-3.02; p = 0.002), whereas cryotherapy more frequently led to vesicles and blisters. Conclusion Lesion clearance may depend on location. It is comparable for head and face lesions, while data from one trial suggests cryotherapy may be better for extremity lesions. PDT is associated with a higher occurrence of pain/burning, while cryotherapy leads to more vesicles/blisters. Future research should focus on standardized protocols, including blinded post-treatment assessments to improve reliability and minimize bias.
Keywords:
actinic keratosis
aminolevulinic acid hydrochloride
cryotherapy
methyl aminolevulinate
photodynamic therapy
Journal
J
IF:
2.5
Papers:
396
Citations:
9.6K
Organization
Cited Papers