Topical 5-aminolevulinic acid-mediated photodynamic therapy for oral verrucous hyperplasia, oral leukoplakia and oral erythroleukoplakia

Background: Our previous studies showed that a new topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) protocol using a light-emitting diode (LED) light source is an effective and successful treatment modality for oral verrucous hyperplasia (OVH). In this study, we reported and compared the clinical outcomes of 24 OVH lesions, 97 oral leukoplakia (OL) lesions and 6 oral erythroleukoplakia (OEL) lesions treated with topical ALA-PDT in the National Taiwan University Hospital, Taipei, Taiwan from November 2001 to December 2005. Methods: Twenty-four OVH lesions, 65 OL lesions and 6 OEL lesions were treated with topical ALA-PDT once a week and 32 OL lesions were treated with the same topical ALA-PDT twice a week. Their clinical outcomes between two different groups were compared by Chi-square test. Results: All the 24 OVH lesions treated once a week showed complete response (CR) after 1-6 (mean, 3.5) treatments of ALA-PDT. The 65 OL lesions treated with topical ALA-PDT once a week showed CR in 5, partial response (PR) in 33 and no response (NR) in 27. The 32 OL lesions treated with the same topical ALA-PDT twice a week demonstrated CR in 11 and PR in 21. The 32 OL lesions treated twice a week had a significantly better clinical outcome than the 65 OL lesions treated once a week (P < 0.001). The six OEL lesions treated with topical ALA-PDT once a week showed CR in four and PR in two. The 6 OEL lesions treated once a week had a significantly better clinical outcome than the 65 OL lesions treated once a week (P < 0.001). Conclusion: We conclude that complete regression of OVH lesions can be achieved by less than seven treatments of topical ALA-PDT once a week. OL lesions treated twice a week have a significantly better clinical outcome than OL lesions treated once a week. In addition, OEL lesions treated once a week have a significantly better clinical outcome than OL lesions treated once a week.