Topical photodynamic therapy is very effective for oral verrucous hyperplasia and oral erythroleukoplakia.
BACKGROUND
Oral verrucous hyperplasia (OVH) and oral erythroleukoplakia (OEL) are two oral precancerous lesions with relatively high malignant transformation potential. One of the best cancer prevention strategies is to use a conservative and effective treatment modality to eliminate oral precancers to stop their further malignant transformation. Our previous studies have shown that the topical 5-aminolevulinic acid-mediated photodynamic therapy (topical ALA-PDT) using the 635-nm light-emitting diode (LED) light is very effective for OVH and OEL lesions.


METHODS
Because the laser machine is a more-popular light source than the LED device in PDT clinics, in this study 40 OVH and 40 OEL lesions were treated once a week with the same PDT protocol but using the 635-nm laser light to evaluate whether this laser light-mediated topical ALA-PDT was also effective for OVH and OEL lesions.


RESULTS
We found that all the 40 OVH lesions exhibited complete response (CR) after an average of 3.6 PDT treatments. Of the 40 OEL lesions, 38 showed CR after an average of 3.4 PDT treatments and two showed partial response (PR). Better PDT outcomes were significantly associated with OVH and OEL lesions with the smaller size, pink to red color, epithelial dysplasia, or thinner surface keratin layer.


CONCLUSIONS
This study indicates that the laser light-mediated topical ALA-PDT is also very effective for OVH and OEL lesions. Therefore, we suggest that topical ALA-PDT using either the LED or laser light may serve as the first-line treatment of choice for OVH and OEL lesions.
Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
Hung-Pin
HP
Lin
Hsin-Ming
HM
Chen
Chuan-Hang
CH
Yu
Hsiang
H
Yang
Yi-Ping
YP
Wang
Chun-Pin
CP
Chiang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000627:therapeutic use; D001706:Biopsy; D002278:Carcinoma in Situ / Q000188:drug therapy / Q000473:pathology; D004919:Erythroplasia / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007633:Keratins / Q000187:drug effects; D007972:Leukoplakia, Oral / Q000188:drug therapy* / Q000473:pathology; D028022:Low-Level Light Therapy; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects* / Q000473:pathology; D009062:Mouth Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011230:Precancerous Conditions / Q000188:drug therapy* / Q000473:pathology; D012074:Remission Induction; D016896:Treatment Outcome
D017319:Photosensitizing Agents; D007633:Keratins; D000622:Aminolevulinic Acid