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Photodiagnosis and Photodynamic Therapy Mar 2023Extrahepatic cholangiocarcinoma (ECC) is a tumor with high invasiveness and poor outcome. The current treatments for unresected ECC are not ideal. Novel strategies are... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Extrahepatic cholangiocarcinoma (ECC) is a tumor with high invasiveness and poor outcome. The current treatments for unresected ECC are not ideal. Novel strategies are needed to improve the outcomes of patients with unresected ECC. Photodynamic therapy (PDT) plus chemotherapy is one of the promising interventions for ECC patients. We conducted this systematic review to determine the efficacy and safety of PDT plus chemotherapy in unresected ECC patients.
METHODS
Databases of PubMed, Cochrane Library, Embase, and Web of science were searched from inception to July 2022. Studies that compared PDT plus chemotherapy to PDT alone or chemotherapy alone in patients with unresected ECC were included. Hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were pooled for overall survival (OS) and adverse events, respectively.
RESULTS
Seven eligible studies were finally included. There are four studies on PDT plus chemotherapy vs. chemotherapy alone and three studies on PDT plus chemotherapy vs. PDT alone. The meta-analysis showed that PDT plus chemotherapy had a significantly better OS than chemotherapy or PDT alone (PDT+chemotherapy vs. chemotherapy alone, HR: 0.69, p = 0.02; PDT+chemotherapy vs. PDT alone, HR:0.36, p<0.01). The occurrence of cholangitis, abscess, and photosensitivity reaction in PDT plus chemotherapy were comparable to either chemotherapy alone or PDT alone (p>0.05).
CONCLUSION
The combination of PDT and chemotherapy can improve patient survival for unresected ECC without increased adverse events. It may be a potential standard therapy in the future management of ECC.
Topics: Humans; Photochemotherapy; Bile Duct Neoplasms; Photosensitizing Agents; Cholangiocarcinoma; Antineoplastic Combined Chemotherapy Protocols; Bile Ducts, Intrahepatic
PubMed: 36738903
DOI: 10.1016/j.pdpdt.2023.103318 -
Photobiomodulation, Photomedicine, and... Aug 2023This systematic review aimed to assess the influence of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical debridement (MD) on peri-implant clinical... (Meta-Analysis)
Meta-Analysis Review
Clinical and Radiographic Outcomes of Adjunctive Photodynamic Therapy for Treating Peri-Implant Mucositis Among Cigarette Smokers and Diabetics: A Systematic Review and Meta-Analysis.
This systematic review aimed to assess the influence of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical debridement (MD) on peri-implant clinical and radiographic outcomes among cigarette smokers and diabetics with peri-implant mucositis (piM). Randomized controlled trials, assessing the clinical and radiographic parameters of aPDT versus MD alone among smokers and diabetics with piM, were included in the study. Meta-analyses were conducted to calculate the standard mean difference with a 95% confidence interval. The methodological quality of the included studies was assessed utilizing the modified Jadad quality scale. The meta-analyses found statistically significant differences between the impact of adjunct aPDT and MD alone on the peri-implant plaque index (PI), probing depth (PD), and bleeding on probing among smokers and diabetics with piM at the final follow-up visit. However, no significant differences were found between the impact of adjunct aPDT and MD alone on the peri-implant crestal bone loss among smokers and diabetics with piM at the final follow-up. The application of aPDT as an adjunctive to MD demonstrated improved scores of the peri-implant clinical parameters among smokers and diabetics with piM in comparison with MD alone.
Topics: Humans; Smokers; Combined Modality Therapy; Mucositis; Debridement; Photochemotherapy; Peri-Implantitis; Anti-Infective Agents; Tobacco Products; Diabetes Mellitus
PubMed: 37506360
DOI: 10.1089/photob.2023.0046 -
Journal of Cataract and Refractive... May 2024Corneal crosslinking (CXL) is used for treating keratoconus and post-laser in situ keratomileusis ectasia. However, refractive surgery is not usually performed with... (Meta-Analysis)
Meta-Analysis Comparative Study
Corneal crosslinking (CXL) is used for treating keratoconus and post-laser in situ keratomileusis ectasia. However, refractive surgery is not usually performed with prophylactic CXL. Therefore, we performed a meta-analysis comparing outcomes of refractive surgeries with vs without prophylactic CXL. We systematically searched databases for studies comparing refractive surgeries for myopic correction with vs without prophylactic corneal crosslinking. Review Manager 5.4.1 was used to perform statistical analysis. We included 2820 eyes from 28 studies. Compared with refractive surgery alone, surgery with prophylactic CXL resulted in decreased central corneal thickness, corrected distance visual acuity logMAR, and safety and efficacy indices. There were no significant differences in postoperative uncorrected distance visual acuity of 20/20 or better at ≥12 months and other visual outcomes among both groups. More randomized controlled trials with standard crosslinking protocols are needed to analyze the prophylactic use of crosslinking with refractive surgeries.
Topics: Humans; Cross-Linking Reagents; Photosensitizing Agents; Keratomileusis, Laser In Situ; Riboflavin; Collagen; Visual Acuity; Myopia; Photorefractive Keratectomy; Photochemotherapy; Lasers, Excimer; Corneal Stroma; Ultraviolet Rays; Keratoconus; Corneal Surgery, Laser; Refraction, Ocular
PubMed: 38288954
DOI: 10.1097/j.jcrs.0000000000001405 -
Photodiagnosis and Photodynamic Therapy Dec 2020This is a systematic review and meta-analysis on the effectiveness of Photodynamic Therapy (PDT) in Bowen's Disease (BD), with further summary of the data from all... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This is a systematic review and meta-analysis on the effectiveness of Photodynamic Therapy (PDT) in Bowen's Disease (BD), with further summary of the data from all randomized controlled trials (RCTs).
METHODS
Relevant data were extracted after conducting a literature search via PubMed, Embase, Scopus, the Cochrane Library, CNKI, and Wanfang databases, from inception until 31 July 2019. Meta-analyses of the data were performed using RevMan V.5.3. A total of 392 published RCTs related to the efficacy of PDT in BD treatment were identified. The papers were screened for duplicates and excluded based on title and abstract. Subsequently, 85 full-text articles were thoroughly reviewed and finally, data from 446 patients with 1147 skin lesions across 12 eligible studies were collated.
RESULTS
Our findings revealed significant differences between the efficacies of PDT and other treatments, where a higher lesion reduction rate was observed after the first treatment session following PDT (P < 0.00001, Z = 4.98). PDT was found to be more effective than 5-fluorouracil (P < 0.00001, Z = 4.42) and cryotherapy (P = 0.008, Z = 2.67). However, there were no significant differences in recurrence rates following treatments with PDT, cryotherapy, and 5-fluorouracil.
CONCLUSIONS
This systematic review and meta-analysis confirms and collates data from all RCTs pertaining to the efficacy of PDT for BD treatment. Our study has reiterated that PDT is more effective than 5-fluorouracil and cryotherapy for the treatment of BD.
Topics: Bowen's Disease; Humans; Neoplasm Recurrence, Local; Photochemotherapy; Photosensitizing Agents; Randomized Controlled Trials as Topic; Skin Neoplasms; Treatment Outcome
PubMed: 33011394
DOI: 10.1016/j.pdpdt.2020.102037 -
Photodiagnosis and Photodynamic Therapy Mar 2022To evaluate the effectiveness of Photodynamic Therapy (PDT) in the treatment of Oral Potentially Malignant Disorders (OPMDs) patients. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To evaluate the effectiveness of Photodynamic Therapy (PDT) in the treatment of Oral Potentially Malignant Disorders (OPMDs) patients.
METHODOLOGY
An electronic search was conducted to retrieve articles published until September 2021. Meta-analyses were conducted for the outcomes of complete response (CR) and any response (AR) after treatment with PDT using data from single-arm studies, case series and non-randomised controlled trials (NRCTs).
RESULTS
In total, 49 articles were included. RCTs revealed insignificant mean difference (MD) in efficacy index between PDT and comparison groups (MD: 1.32; 95% CI:-28.10-30.72, p=0.930). The likelihood of CR (OR:0.84; 95% CI: 0.42-1.71, p=0.637) or AR (OR:2.10; 95% CI: 0.31-14.25, p=0.448) was not different in PDT group when compared with any comparison treatments in NRCTs. CR/AR among single arm studies was 60.6% (95% CI: 50.5-70.7, P<0.001) and 93.7% (95% CI:91.5-95.8, P<0.001) respectively. Higher prevalence of CR and AR was observed for dysplasia or carcinoma insitu (CIS) (CR: 81%, 95% CI: 70.8-91.3, P<0.001; AR: 94.3%; 95% CI: 89-99.6, P<0.001) and actinic cheilitis (AC) (CR: 73.9%, 95% CI: 65.9-81.9, P<0.001; AR:97%; 95% CI:94.9-99, P<0.001).
CONCLUSIONS
More than half of the patients receiving PDT showed CR, with more than 90% responding to the treatment. PDT was most effective on oral dysplasias, followed by AC.
Topics: Cheilitis; Humans; Mouth Diseases; Photochemotherapy; Precancerous Conditions
PubMed: 34999271
DOI: 10.1016/j.pdpdt.2022.102713 -
Photodiagnosis and Photodynamic Therapy Jun 2022Oral potentially malignant disorders (OPMD) represent a group of lesions with increased risk for malignant transformation. The management of such injuries is based on... (Meta-Analysis)
Meta-Analysis Review
Oral potentially malignant disorders (OPMD) represent a group of lesions with increased risk for malignant transformation. The management of such injuries is based on surgical treatment or detailed follow-up throughout the patient's lifetime. This systematic review and meta-analysis investigated and critically evaluated the use of autofluorescence and fluorescent probes as potential techniques for the early detection of OPMD. A comprehensive search was performed on Pubmed, Scopus, Web of Science and LIVIVO databases. The gray literature was also consulted and included Google Scholar, Proquest and Open gray databases. 2715 articles were retrieved, and after the different stages of critical evaluation, were reduced to 25 articles that fully met the inclusion criteria. VELscope® was the most used equipment for autofluorescence, while aminolevulinic acid (5-ALA) was the main representative of the probes. The meta-analysis performed included 10 articles that used VELscope® as a method to detect oral disorders. A 95% confidence interval (CI) with a p value significance <0.05 was considered as a criterion for the statistical analysis. The combined sensitivity was 74% (CI95 60-76%, p = 0.0001) and the specificity was 57% (CI95 52-60%, p = 0.0000). The inclusion of these adjunct methods in clinical practice is very promising, since they are able to help both the clinician and the specialist in the early detection of potentially malignant oral disorders, favoring a better prognosis. However, it is still necessary to carry out further studies, with the aim of establishing a protocol for use and qualification of results.
Topics: Data Analysis; Early Detection of Cancer; Fluorescent Dyes; Humans; Mouth Diseases; Mouth Neoplasms; Photochemotherapy; Precancerous Conditions
PubMed: 35192945
DOI: 10.1016/j.pdpdt.2022.102764 -
Acta Dermato-venereologica Jan 2021A systematic literature review was conducted to identify and qualitatively assess randomized controlled trials in immunocompetent patients ≥ 18 years with head-... (Meta-Analysis)
Meta-Analysis
A systematic literature review was conducted to identify and qualitatively assess randomized controlled trials in immunocompetent patients ≥ 18 years with head- region lesions of actinic keratoses who were treated with field-directed, lesion-directed and other therapies. Network meta-analysis was used to quantitatively evaluate field-directed therapies (5-fluorouracil formulations, diclofenac sodium, imiquimod, ingenol mebutate, 5-aminolevulinic acid or methyl aminolevulinate plus photodynamic therapy) using complete clearance or partial clearance of actinic keratoses lesions, and adverse event-related withdrawals as a proxy of acceptability. Of 2,863 references identified, 75 trials reported in 151 publications were included. In summary, comparative network meta-analysis evaluation showed that 5-fluorouracil formulations were the most efficacious interventions examined. 5-fluorouracil 4%, which was recently approved, showed a comparable efficacy profile to 5-fluorouracil 5%, and had satisfactory acceptability outcomes.
Topics: Diterpenes; Humans; Imiquimod; Keratosis, Actinic; Network Meta-Analysis; Photochemotherapy; Treatment Outcome
PubMed: 33170301
DOI: 10.2340/00015555-3690 -
Photodiagnosis and Photodynamic Therapy Mar 2023The objective of this systematic review and meta-analysis (SRMA) was to investigate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The objective of this systematic review and meta-analysis (SRMA) was to investigate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of endodontic sealers to intraradicular dentin.
METHODS
This SRMA followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD42022319856). A population, intervention, control, and outcome (PICO) question was formulated: "Does antimicrobial photodynamic therapy decrease the bond strength of root canal sealers?". A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases until July 2022. Joanna Briggs Institute Critical Assessment Guidelines for Quasi-Experimental Studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (p<0.05).
RESULTS
Out of an initial 345 articles, 8 in vitro studies were included, published between 2013 and 2022. The studies were qualitatively analyzed; two studies showed a positive effect, two studies a negative effect, and the other studies showed no effect on bond strength of endodontic sealers to intraradicular dentin. Seven of the studies were included in the SRMA, which indicated that there was no significant difference in bond strength when using aPDT (P = 0.90; MD: -0.03; 95% CI: -0.46 to -0.41). There was a high level of evidence for each meta-analysis outcome.
CONCLUSION
It can be concluded that the use of aPDT as a method of root canal disinfection does not negatively influence the bond strength of endodontic sealers in the root canal.
Topics: Root Canal Filling Materials; Photochemotherapy; Dentin; Photosensitizing Agents; Anti-Infective Agents; Materials Testing
PubMed: 36596331
DOI: 10.1016/j.pdpdt.2022.103270 -
Does aPDT reduce bacterial load in endodontic infected teeth? A systematic review and meta-analysis.Lasers in Medical Science Nov 2023This systematic review investigated whether antimicrobial photodynamic therapy (aPDT) after chemomechanical root canal disinfection (CD) yields a greater microbial load... (Meta-Analysis)
Meta-Analysis Review
This systematic review investigated whether antimicrobial photodynamic therapy (aPDT) after chemomechanical root canal disinfection (CD) yields a greater microbial load reduction than only CD. An electronic literature search was conducted on four databases up to November 2022, with no language or publication date restrictions. Randomized and non-randomized clinical trials were included if participants had a primary endodontic infection in permanent teeth, and if microbial loads before and after using aPDT were compared. Two researchers independently screened titles and abstracts to determine study eligibility. Assessments included risk of bias and methodological quality. This review was registered in PROSPERO (CRD42020181783). Eight studies were included in the qualitative analysis, and six were eligible for meta-analysis. In the random effects model, aPDT significantly improved the results of root canal disinfection when compared with standard protocols for cleaning and shaping (p = 0.04, 95% CI -1.72, -0.05). Subgroup analysis suggested that aPDT has a better effect on reducing the load of anaerobic microorganisms (p = 0.003, 95% CI -3.36, -0.69). The use of aPDT as an adjunct to chemomechanical disinfection promotes additional reduction of the microbial load and, therefore, seems to improve the results of root canal treatments in permanent teeth with a primary endodontic infection. However, certainty of evidence should be improved.
Topics: Humans; Bacterial Load; Anti-Infective Agents; Disinfection; Photochemotherapy; Root Canal Therapy
PubMed: 37981598
DOI: 10.1007/s10103-023-03938-4 -
Bosnian Journal of Basic Medical... Oct 2022This systematic review and meta-analysis aimed to assess the extent of clinical attachment loss (CAL) as a clinical parameter in the efficacy of antimicrobial... (Meta-Analysis)
Meta-Analysis Review
Clinical attachment loss in the use of adjunctive antimicrobial photodynamic therapy in Stages II-IV Grade C molar-incisor periodontitis: A systematic review and meta-analysis.
This systematic review and meta-analysis aimed to assess the extent of clinical attachment loss (CAL) as a clinical parameter in the efficacy of antimicrobial photodynamic therapy (aPDT) in non-surgical management of stage II-IV grade C molar-incisor pattern Periodontitis. This review protocol was conducted in accordance with PRISMA statements and is registered in PROSPERO (CRD42022321211). An electronic and manual search was conducted for relevant articles comparing the efficacy of aPDT versus scaling and root planning (SRP) alone or with amoxicillin/metronidazole (AMX/MET) published up until December 2021. The mean clinical attachment loss (CAL), probing depth (PD) reduction, and bleeding on probing (BOP) with a 95% confidence interval (CI) were pooled and compared between the two groups with CAL < and > 7 mm using a random-effect model after 3 and 6 months. To assess the heterogeneity of the findings, the I2 test was applied and Publication bias was evaluated by visual examination of the funnel plot symmetry. Analysis of 9 studies indicated a significant difference in clinical attachment gain in patients with CAL > 7 mm between the aPDT group and the SRP alone (mean difference=0.92, 95% CI=0.01-1.84, P=0.05) and SRP + AMX/MET (mean difference=0.91, 95% CI=-0.14-1.68, P=0.02) control groups. However, this difference was not significant in patients with CAL < 7 mm. Despite the limitations of the included studies, aPDT can be suggested for the improvement of clinical parameters in grade C molar-incisor pattern Periodontitis with CAL > 7 mm. However, its application in milder cases requires further investigation.
Topics: Humans; Photochemotherapy; Metronidazole; Chronic Periodontitis; Incisor; Anti-Bacterial Agents; Amoxicillin; Anti-Infective Agents
PubMed: 35656837
DOI: 10.17305/bjbms.2022.7157