Real world data of 5-aminolevulinic acid-mediated photodynamic therapy for Bowen’s disease: A 10-year retrospective study in China (2010-2020)
Background: Photodynamic therapy (PDT) has been recommended as a first-line treatment for Bowen’s disease (BD). However, data on 5-aminolevulinic acid-mediated PDT (ALA-PDT) are limited, and long-term efficacy remains to be determined, especially in dark-skinned populations. Objective: To review the results of BD treated with ALA-PDT, and try to explore the risk predictors of curative effect in a real-world setting. Methods: This study is based on a retrospective analysis of the clinical data of BD patients, who received ALA-PDT with red light irradiation between February 2010 and June 2020. Univariate and multivariate analyses of clinically relevant variables that may affect treatment outcomes were performed to identify significant risk predictors. Results: The overall clearance rate of 122 BD lesions was 89.3%. Fluorescence intensity of pre-PDT and PDT sessions were statistically significant after eliminating the interference of confounding factors. The mean follow-up time was 3.1 years. All recurrences occurred in the first two years following ALA-PDT. Limitations: A single-institution retrospective study with a limited scale and the possibility of information bias. Conclusion: ALA-PDT is an effective and alternative treatment for BD. Well-regulated operation and effective pre-treatment are the determinants of efficacy. Fluorescence intensity of pre-PDT and tumor size appeared to be significant predictors of final efficacy. In addition, two years of follow-up is necessary following ALA-PDT.