title: Switching From Conventional Photodynamic Therapy to Daylight Photodynamic Therapy For Actinic Keratoses: Systematic Review and Meta-analysis.
abstract: Actinic keratosis is a precursor lesion to the most common nonmelanoma skin cancer. Conventional photodynamic therapy (PDT) has been shown to be effective, but the procedure is time-consuming, can be very painful, and requires infrastructure. These shortcomings led to the emergence of daylight PDT. To obtain a global estimate of efficacy, we undertook a systematic literature review and performed a meta-analysis of the available evidence on the efficacy and safety of daylight PDT as compared to conventional PDT in the treatment of actinic keratosis and/or field cancerization. The conclusion is that the difference in efficacy is clinically negligible (global estimate of the mean response rate difference, -3.69%; 95% CI, -6.54% to -0.84%). The adverse effects of daylight PDT are mild and localized (79% of patients report no discomfort), and patients report less pain (P<.001). Daylight PDT gives good to excellent cosmetic results in more than 90% of patients, and patient satisfaction is greater (P<.001).
authors.affiliation: Departamento de Dermatología, Clínica Universidad de Navarra, Pamplona, España. Electronic address: atomas.1@alumni.unav.es.
authors.forename: A
authors.initials: A
authors.lastname: Tomás-Velázquez
authors.affiliation: Departamento de Dermatología, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: P
authors.initials: P
authors.lastname: Redondo
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000517:prevention & control; D017326:Clinical Trials, Phase III as Topic; D004954:Esthetics; D006801:Humans; D055623:Keratosis, Actinic / Q000188:drug therapy*; D009381:Neoplasms, Radiation-Induced / Q000517:prevention & control; D010084:Oxidation-Reduction; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D010777:Photochemistry; D010778:Photochemotherapy / Q000009:adverse effects / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013472:Sunlight / Q000009:adverse effects; D014466:Ultraviolet Rays / Q000009:adverse effects
chemical_list: D017319:Photosensitizing Agents
keywords: Actinic keratosis; Daylight photodynamic therapy; Photodynamic therapy; Queratosis actínicas; Terapia fotodinámica; Terapia fotodinámica con luz de día; Tratamiento; Treatment