PDT combined with liquid nitrogen cryotherapy is superior to PDT alone in Actinic Keratosis

Background: Actinic keratosis (AK) possesses the potential to progress into squamous cell carcinoma (SCC). Aminolevulinic acid photodynamic therapy (ALA-PDT) is acknowledged as a preferred treatment modality for AK. To improve clinical clearance rates, combination strategies that integrate PDT with...

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Main Authors: Xianmin Meng, Chaofeng Xia, Hong Luan, Wenhui Liu, Yongguo Li
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Photodiagnosis and Photodynamic Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S1572100025002054
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author Xianmin Meng
Chaofeng Xia
Hong Luan
Wenhui Liu
Yongguo Li
author_facet Xianmin Meng
Chaofeng Xia
Hong Luan
Wenhui Liu
Yongguo Li
author_sort Xianmin Meng
collection DOAJ
description Background: Actinic keratosis (AK) possesses the potential to progress into squamous cell carcinoma (SCC). Aminolevulinic acid photodynamic therapy (ALA-PDT) is acknowledged as a preferred treatment modality for AK. To improve clinical clearance rates, combination strategies that integrate PDT with other therapeutic approaches are often utilized. This study seeks to assess the therapeutic efficacy and safety profile of combining cryotherapy with PDT in the management of AK. Methods: In this single-center study, 66 patients with histopathologically and/or dermatoscopically confirmed actinic keratosis were enrolled. Participants were randomly allocated into two groups: one receiving liquid nitrogen cryotherapy combined with photodynamic therapy (LN-PDT) and the other receiving control photodynamic therapy (C-PDT), comprising 35 and 31 patients, respectively. Follow-up was conducted for a minimum duration of 6 months. Dermoscopy follow-up examinations were systematically performed at 3-month and 6-month intervals post-final treatment. The primary outcome measure was the rate of initial complete clearance at the 3-month mark, whereas the secondary outcome focused on sustained complete clearance at 6 months. Treatment efficacy and adverse reaction profiles were meticulously documented and underwent comparative analysis between the two therapeutic groups. Results: At the 3-month follow-up post-final treatment, the initial complete clearance rates were 93.6 % and 68.4 % in the two respective groups, indicating a statistically significant difference (P < 0.05). At the 6-month follow-up, sustained complete clearance rates were 95.1 % and 72.6 % in the respective groups, with similarly significant intergroup statistical differences P < 0.05). Conclusion: For the treatment of actinic keratosis (AK) lesions, the combination of liquid nitrogen cryotherapy and photodynamic therapy was more therapeutically effective than photodynamic therapy alone.
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spelling doaj-art-6c99b0c64d314ad4b64d0decd0ac11b82025-06-26T09:52:09ZengElsevierPhotodiagnosis and Photodynamic Therapy1572-10002025-08-0154104673PDT combined with liquid nitrogen cryotherapy is superior to PDT alone in Actinic KeratosisXianmin Meng0Chaofeng Xia1Hong Luan2Wenhui Liu3Yongguo Li4Department of Dermatology, Liaocheng People's Hospital, No. 67 West Dongchang Road Liaocheng, Shandong, PR ChinaDepartment of Anorectal Surgery, Liaocheng People's Hospital, No. 67 West Dongchang Road Liaocheng, Shandong, PR ChinaDepartment of Dermatology, Liaocheng People's Hospital, No. 67 West Dongchang Road Liaocheng, Shandong, PR ChinaDepartment of Dermatology, Liaocheng People's Hospital, No. 67 West Dongchang Road Liaocheng, Shandong, PR China; Corresponding author at: Department of Dermatology (W.Liu), Department of Stomatology (Y.Li), Liaocheng People's Hospital, No. 67 West Dongchang Road Liaocheng, Shandong, PR China.Department of Stomatology, Liaocheng People's Hospital, No. 67 West Dongchang Road Liaocheng, Shandong, PR China; Corresponding author at: Department of Dermatology (W.Liu), Department of Stomatology (Y.Li), Liaocheng People's Hospital, No. 67 West Dongchang Road Liaocheng, Shandong, PR China.Background: Actinic keratosis (AK) possesses the potential to progress into squamous cell carcinoma (SCC). Aminolevulinic acid photodynamic therapy (ALA-PDT) is acknowledged as a preferred treatment modality for AK. To improve clinical clearance rates, combination strategies that integrate PDT with other therapeutic approaches are often utilized. This study seeks to assess the therapeutic efficacy and safety profile of combining cryotherapy with PDT in the management of AK. Methods: In this single-center study, 66 patients with histopathologically and/or dermatoscopically confirmed actinic keratosis were enrolled. Participants were randomly allocated into two groups: one receiving liquid nitrogen cryotherapy combined with photodynamic therapy (LN-PDT) and the other receiving control photodynamic therapy (C-PDT), comprising 35 and 31 patients, respectively. Follow-up was conducted for a minimum duration of 6 months. Dermoscopy follow-up examinations were systematically performed at 3-month and 6-month intervals post-final treatment. The primary outcome measure was the rate of initial complete clearance at the 3-month mark, whereas the secondary outcome focused on sustained complete clearance at 6 months. Treatment efficacy and adverse reaction profiles were meticulously documented and underwent comparative analysis between the two therapeutic groups. Results: At the 3-month follow-up post-final treatment, the initial complete clearance rates were 93.6 % and 68.4 % in the two respective groups, indicating a statistically significant difference (P < 0.05). At the 6-month follow-up, sustained complete clearance rates were 95.1 % and 72.6 % in the respective groups, with similarly significant intergroup statistical differences P < 0.05). Conclusion: For the treatment of actinic keratosis (AK) lesions, the combination of liquid nitrogen cryotherapy and photodynamic therapy was more therapeutically effective than photodynamic therapy alone.http://www.sciencedirect.com/science/article/pii/S1572100025002054Actinic keratosis;5-Aminolevulinic acid;Photodynamic therapy;Liquid nitrogen cryotherapy
spellingShingle Xianmin Meng
Chaofeng Xia
Hong Luan
Wenhui Liu
Yongguo Li
PDT combined with liquid nitrogen cryotherapy is superior to PDT alone in Actinic Keratosis
Photodiagnosis and Photodynamic Therapy
Actinic keratosis;5-Aminolevulinic acid;Photodynamic therapy;Liquid nitrogen cryotherapy
title PDT combined with liquid nitrogen cryotherapy is superior to PDT alone in Actinic Keratosis
title_full PDT combined with liquid nitrogen cryotherapy is superior to PDT alone in Actinic Keratosis
title_fullStr PDT combined with liquid nitrogen cryotherapy is superior to PDT alone in Actinic Keratosis
title_full_unstemmed PDT combined with liquid nitrogen cryotherapy is superior to PDT alone in Actinic Keratosis
title_short PDT combined with liquid nitrogen cryotherapy is superior to PDT alone in Actinic Keratosis
title_sort pdt combined with liquid nitrogen cryotherapy is superior to pdt alone in actinic keratosis
topic Actinic keratosis;5-Aminolevulinic acid;Photodynamic therapy;Liquid nitrogen cryotherapy
url http://www.sciencedirect.com/science/article/pii/S1572100025002054
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