European Dermatology Forum guidelines on topical photodynamic therapy 2019 Part 1: treatment delivery and established indications - actinic keratoses, Bowen's disease and basal cell carcinomas
European Dermatology Forum guidelines on topical photodynamic therapy 2019 Part 1: treatment delivery and established indications - actinic keratoses, Bowen's disease and basal cell carcinomas
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DOI：
10.1111/jdv.16017
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发表时间：
2019-12-01
影响因子：
9.2
通讯作者：
Braathen, L. R.
中科院分区：
文献类型：
--
作者：
Morton, C. A.;Szeimies, R-M;Braathen, L. R.
局部光动力疗法(PDT)是一种被广泛认可的治疗光化性角化病、鲍温病(原位鳞状细胞癌)、浅表性和某些薄基底细胞癌的方法。使用标准治疗方案的复发率通常与现有治疗方法相同，但不如结节状基底细胞癌的手术治疗。光动力疗法既可用于皮损治疗，也可用于野战治疗，并有可能延缓/减少新病变的发展。一种利用日光治疗光化性角化病的方案被广泛应用，传统的光动力疗法通常在闭塞3小时后使用红光，用于其他浅表皮肤癌的适应症，以及当日光疗法不可行时用于光化性角化病。PDT是一种耐受性良好的疗法，尽管与传统方案相关的不适可能需要减轻疼痛的措施。日光下的光动力疗法与无疼痛或轻微疼痛有关，患者更喜欢使用。有一种新的文献关于加强传统的PDT方案或将PDT与另一种治疗方法相结合以提高缓解率。这份指南分两部分出版，考虑了所有目前批准的和正在出现的皮肤科使用局部PDT的适应症，由欧洲皮肤病论坛指南委员会的PDT小组编写。它提出了一致同意的专家建议，反映了目前公布的证据。
Topical photodynamic therapy (PDT) is a widely approved therapy for actinic keratoses, Bowen's disease (squamous cell carcinoma in situ), superficial and certain thin basal cell carcinomas. Recurrence rates when standard treatment protocols are used are typically equivalent to existing therapies, although inferior to surgery for nodular basal cell carcinoma. PDT can be used both as lesional and field therapies and has the potential to delay/reduce the development of new lesions. A protocol using daylight to treat actinic keratoses is widely practised, with conventional PDT using a red light after typically a 3-h period of occlusion employed for other superficial skin cancer indications as well as for actinic keratoses when daylight therapy is not feasible. PDT is a well-tolerated therapy although discomfort associated with conventional protocol may require pain-reduction measures. PDT using daylight is associated with no or minimal pain and preferred by patient. There is an emerging literature on enhancing conventional PDT protocols or combined PDT with another treatment to increase response rates. This guideline, published over two parts, considers all current approved and emerging indications for the use of topical PDT in dermatology, prepared by the PDT subgroup of the European Dermatology Forum guidelines committee. It presents consensual expert recommendations reflecting current published evidence.