光动力疗法治疗口腔潜在恶性疾病的临床疗效:系统综述和荟萃分析

IF 4.1 4区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Evidence-Based Dental Practice Pub Date : 2024-06-01 DOI:10.1016/j.jebdp.2023.101899
MARIELA PERALTA-MAMANI , BRUNA MACHADO DA SILVA , HEITOR MARQUES HONÓRIO , IZABEL REGINA FISCHER RUBIRA-BULLEN , REEM HANNA , PAULO SERGIO SANTOS DA SILVA
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引用次数: 0

摘要

目的:尽管光疗(以光动力疗法(PDT)介导的氧化应激形式)被用于治疗口腔潜在恶性疾病(OPMDs),但其确定性证据仍不明确。因此,本系统综述和荟萃分析(PROSPERO # CRD42021218748)旨在评估 PDT 诱导的氧化应激在口腔潜在恶性疾病中的临床疗效 方法:不限语言和出版年份,检索了 PubMed、Embase、Web of Science、Scopus 和 Cochrane Library 等数据库。此外,还检索了灰色文献并进行了人工检索。两位独立审稿人对所有研究进行了筛选,评估了数据提取、偏倚风险和证据确定性。然后进行了叙述性综合分析。在进行荟萃分析时,考虑了随机效应,以确定口腔潜在恶性疾病(OPMD)完全缓解和部分缓解(PR)的患病率。采用建议、评估、发展和评价分级法(GRADE)探讨了证据的确定性:定性和定量综合纳入了 23 项研究。共纳入 880 名患者(564 名男性;218 名女性),年龄介于 24 岁至 89 岁之间。结果显示,以下 OPMLs 的完全缓解率和部分缓解率分别为:光化性咽颊炎 (AC):69.9% 和 2.4%;口腔白斑病 (OL):44% 和 36.9%;口腔溃疡 (OL):44% 和 36.9%;口腔溃疡 (OL):44% 和 36.9%:44% 和 36.9%;口腔疣状增生(OVH):98.5%;口腔红斑(OEL):92.1% 和 7.9%。OL无缓解的发生率为18.8%:PDT在OPMD的临床缓解方面效果显著,大多数符合条件的研究都显示了所包含病变的完全或部分缓解,但证据的确定性较低或很低。因此,有必要进一步开展方法严谨的临床研究,以提供更多经过验证的数据。此外,还需要更多证据来进一步了解 PDT 诱导氧化应激的机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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CLINICAL EFFICACY OF PHOTODYNAMIC THERAPY IN MANAGEMENT OF ORAL POTENTIALLY MALIGNANT DISORDERS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Objectives

Despite phototherapy (in the form of photodynamic therapy (PDT)-mediated oxidative stress) being utilized in the management of oral potentially malignant disorders (OPMDs), the evidence of certainty remains unclear. Hence, this systematic review and meta-analysis (PROSPERO # CRD42021218748) is aimed to evaluate the clinical efficacy of PDT-induced oxidative stress in OPMDs

Methods

PubMed, Embase, Web of Science, Scopus, and Cochrane Library databases were searched without restriction of language or year of publication. In addition, gray literature was searched and a manual search was performed. Two independent reviewers screened all the studies, assessing data extraction, risk of bias and certainty of evidence. A narrative synthesis was carried out. For the meta-analysis, random effects were considered to determine the prevalence of a total and a partial remission (PR) of oral potentially malignant disorders (OPMDs). The certainty of evidence was explored using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results

Twenty-three studies were included in the qualitative and quantitative syntheses. A total of 880 patients were included (564 males; 218 females) with an age range between 24 and 89-years-old. The results showed the prevalence of the total and partial remissions respectively for the following OPMLs: actinic cheilitis (AC): 69.9% and 2.4%; oral leukoplakia (OL): 44% and 36.9%; oral verrucous hyperplasia (OVH): 98.5%; oral erythroleukoplakia (OEL): 92.1% and 7.9%. The prevalence of no remission of OL was 18.8%.

Conclusions

PDT demonstrated significant results in clinical remission of OPMDs and most of the eligible studies have shown a total or a partial remission of the included lesions, but at a low or a very low certainty of evidence. Hence, further clinical studies with robust methodology are warranted to offer further validated data. Also, further evidence is required to understand further the mechanism of PDT-induced oxidative stress.

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来源期刊
Journal of Evidence-Based Dental Practice
Journal of Evidence-Based Dental Practice DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
6.00
自引率
16.70%
发文量
105
审稿时长
28 days
期刊介绍: The Journal of Evidence-Based Dental Practice presents timely original articles, as well as reviews of articles on the results and outcomes of clinical procedures and treatment. The Journal advocates the use or rejection of a procedure based on solid, clinical evidence found in literature. The Journal''s dynamic operating principles are explicitness in process and objectives, publication of the highest-quality reviews and original articles, and an emphasis on objectivity.
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