Eficacia clínica de terapia fotodinámica por 5-ALA tópico en el manejo onco-preventivo de lesiones de leucoplasia oral

Abstract

Oral leukoplakia is the most prevalent malignant disorder of the oral mucosa globally and its management remains a challenge. A systematic review was carried out to determine the clinical efficacy of photodynamic therapy mediated by topical 5- aminolevulinic acid, as an alternative for chemoprevention in the different clinical forms of oral leukoplakia. Materials and Methods An exhaustive search was carried out under MeSH terms for clinical trials published in English in the last 30 years, about the use of photodynamic therapy mediated by topical 5-aminolevulinic acid as a photosensitizer, and under low-intensity laser radiation or LED light as a source of light in different digital bases. Results The systematic review under PRISMA guidance recognized an efficacy of 88.6% for this mode of phototherapy in the management of oral leukoplakia, with a greater effect size in the homogeneous clinical forms with dysplastic changes, regardless of the type of light source. However, the evidence used in this analysis was moderate. Conclusion Based on the results of the present study, we can conclude that 5- aminolevulinic acid topical – mediated photodynamic therapy appears to be a high- performance alternative in the oncopreventive management of oral leucoplakia lesions. However, we recommend running controlled and randomized clinical trials with homogeneous methodologies that allow us to generate a meta-analysis with a high level of evidence.