Comparative study of photodynamic therapy vs. CO2 laser vaporization in treatment of condylomata acuminata, a randomized clinical trial
Comparative study of photodynamic therapy vs. CO2 laser vaporization in treatment of condylomata acuminata, a randomized clinical trial
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DOI：
10.1111/j.1365-2133.2006.07648.x
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发表时间：
2007-03-01
影响因子：
10.3
通讯作者：
Gu, H.
中科院分区：
文献类型：
--
作者：
Chen, K.;Chang, B. Z.;Gu, H.
背景大多数治疗尖锐湿疣（CA）的常规疗法都是创伤性的，并且复发率很高。目的探讨外用5-氨基乙酰丙酸（ALA）光动力疗法（PDT）治疗CA的疗效和安全性。方法将65例CA患者分为治疗组（ALA-PDT），用20% ALA溶液在封闭敷料下治疗3 h，然后用100jcm（-2）剂量、100mw功率的氦氖激光照射。另设21例CA患者为对照组，采用CO2激光治疗。如果第一次治疗后病变未完全切除，1周后重复治疗。结果经1次治疗后，ALA-PDT组的完全去除率为95%，对照组为100%。经2次ALA-PDT治疗后，治疗组完全去除率为100%。ALA-PDT组复发率为6.3%，显著低于对照组（19.1%,P < 0.05）。ALA-PDT组不良反应患者比例（13.9%）也显著低于对照组（100%,P < 0.05）。ALA-PDT治疗患者的副作用主要包括仅限于照射区域的轻度灼烧和/或刺痛。结论与常规CO2激光治疗相比，局部应用ALA-PDT治疗CA是一种更简单、有效、安全、复发率低的治疗方法。
Background Most conventional therapies for condylomata acuminata (CA) are traumatic and have high recurrence rates.Objectives To investigate the efficacy and safety of topical application of 5-aminolaevulinic acid (ALA) photodynamic therapy (PDT) for the treatment of CA.Methods Sixty-five patients with CA were allocated into the treatment (ALA-PDT) group and treated with 20% ALA solution under occlusive dressing for 3 h followed by irradiation with the helium-neon laser at a dose of 100 J cm(-2) and a power of 100 mW. Another 21 CA patients were allocated into the control group and treated with the CO2 laser. The treatment was to be repeated 1 week later if the lesion was not completely removed after the first treatment.Results After one treatment, the complete removal rate was 95% in the ALA-PDT group and 100% in the control group. After two treatments with ALA-PDT, the complete removal rate in the treatment group was 100%. The recurrence rate for ALA-PDT group was 6.3% which was significantly lower than that in control group (19.1%, P < 0.05). Moreover, the proportion of patients with adverse effects in the ALA-PDT group (13.9%) was also significantly lower than that in control group (100%, P < 0.05). The side-effects in patients treated with ALA-PDT mainly included mild burning and/or stinging restricted to the illuminated area.Conclusions The present study shows that topical application of ALA-PDT is a simpler, more effective and safer therapy with a lower recurrence for treatment of CA compared with conventional CO2 laser therapy.