Photodynamic therapy does not prevent cutaneous squamous-cell carcinoma in organ-transplant recipients: Results of a randomized-controlled trial
Photodynamic therapy does not prevent cutaneous squamous-cell carcinoma in organ-transplant recipients: Results of a randomized-controlled trial
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DOI：
10.1038/sj.jid.5700098
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发表时间：
2006-03-01
影响因子：
6.5
通讯作者：
Bavinck, Jan N. Bouwes
中科院分区：
文献类型：
--
作者：
de Graaf, Ymke G. L.;Kennedy, Cornelis;Bavinck, Jan N. Bouwes
对40例器官移植受者进行了一项配对观察的随机对照试验，以评估光动力疗法(PDT)对新发鳞状细胞癌的预防作用，并评价PDT对角化性皮肤病变数量的影响。治疗区域由随机分配的前臂和相应的手组成，另一只前臂和手作为对照区域。在初次访问后，计划在两年内每隔3个月进行一次后续访问。治疗组和未治疗组之间新的鳞状细胞癌的发生率在统计学上没有显著差异：经过2年的随访，我们在40个接受PDT治疗的组中有9个观察到15个鳞状细胞癌，在40个对照组中有9个观察到10个鳞癌。角化皮损的数量在两个手臂中都增加了，但在接受PDT治疗的手臂中没有那么明显。经过1年的随访，观察到倾向于接受PDT治疗的ARM，但没有达到统计学意义。近80%的患者报告说，治疗后立即出现了轻微到严重的不良反应，包括疼痛和烧灼感。未发现任何长期不良反应。总之，PDT似乎不能预防器官移植受者新的鳞状细胞癌的发生，但在一定程度上减少了角化性皮肤病变的增加。
A randomized-controlled trial with paired observations was performed with 40 organ-transplant recipients to assess the preventive effect of photodynamic therapy (PDT) on the development of new squamous-cell carcinomas and to evaluate the effect of PDT on the number of keratotic skin lesions. The treatment area consisted of a randomly assigned forearm and the corresponding hand, whereas the other forearm and hand served as the control area. After the initial visit, follow-up visits were scheduled at 3-monthly intervals during 2 years. No statistically significant difference was found in the occurrence of new squamous-cell carcinomas between the treated and untreated arms: after 2 years of follow-up, we observed 15 squamous-cell carcinomas in nine out of 40 PDT-treated arms and 10 squamous-cell carcinomas in nine out of 40 control arms. The number of keratotic skin lesions increased in both arms, but was less pronounced in the PDT-treated arm. After 1 year of follow-up, a trend in favor of the PDT-treated arm was observed, but statistical significance was not reached. Nearly 80% of the patients reported mild to severe adverse effects consisting of pain and a burning sensation, immediately after the treatment. No long-term adverse events were noted. In conclusion, PDT does not appear to prevent the occurrence of new squamous-cell carcinomas in organ-transplant recipients, but to some degree, reduces the increase of keratotic skin lesions.