Lasers in surgery and medicine · 2025
Possible Number of Recommended Sessions and Influential Factors of Hematoporphyrin Monomethyl Ether Photodynamic Therapy for Pulsed Dye Laser-Resistant Facial Port-Wine Stain.
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Lv Yating, Yang Luan, Wei Shufang, Xiangli Xiaoying, Yang Xiaorong, Zhang Xianjun, Zhong Hua
Аннотация
OBJECTIVES: Some patients with port-wine stain (PWS) who have undergone several sessions of pulsed dye laser (PDL) treatment desire further improvement through hematoporphyrin monomethyl ether (HMME) photodynamic therapy (PDT). We attempted to analyse a possible number of recommended sessions and factors influencing the efficacy of multiple sessions of HMME-PDT for facial PDL-resistant PWSs.
METHODS: Forty-eight patients with facial PDL-resistant PWSs who underwent at least three HMME-PDT sessions were included in this study. All patients received an intravenous injection of HMME (5 mg/kg) followed by 532-nm light-emitting diode green light therapy. Cumulative improvement scores and single improvement scores were obtained after each session to evaluate the degree of improvement.
RESULTS: The excellent improvement rates of patients were 0% (0/48), 8.3% (4/48), 29.2% (14/48), 38.5% (10/26), and 50.0% (8/16) after 1-5 HMME-PDT sessions, respectively. A significant difference was observed in the cumulative improvement scores (p < 0.0001). Moreover, there were significant differences between any two sessions in the first four HMME-PDT sessions (p = 0.003). The improvement after the first HMME-PDT session was more obvious than that after each subsequent session (p = 0.004). A PWS less than or equal to 1% of the body surface area (OR = 9.05; 95% CI, 1.42-57.57; p = 0.020) and 5-10 sessions of previous PDL treatment (OR = 8.06; 95% CI, 2.01-32.33; p = 0.003) were positive influential factors for PDL-resistant PWS.
CONCLUSIONS: We propose that at least 4 HMME-PDT sessions could be recommended for patients with PDL-resistant PWSs, and the improvement after the first HMME-PDT session was the most evident compared with that after each subsequent treatment. Moreover, greater erythema and a greater number of previous PDL session were associated with poor HMME-PDT efficacy.
METHODS: Forty-eight patients with facial PDL-resistant PWSs who underwent at least three HMME-PDT sessions were included in this study. All patients received an intravenous injection of HMME (5 mg/kg) followed by 532-nm light-emitting diode green light therapy. Cumulative improvement scores and single improvement scores were obtained after each session to evaluate the degree of improvement.
RESULTS: The excellent improvement rates of patients were 0% (0/48), 8.3% (4/48), 29.2% (14/48), 38.5% (10/26), and 50.0% (8/16) after 1-5 HMME-PDT sessions, respectively. A significant difference was observed in the cumulative improvement scores (p < 0.0001). Moreover, there were significant differences between any two sessions in the first four HMME-PDT sessions (p = 0.003). The improvement after the first HMME-PDT session was more obvious than that after each subsequent session (p = 0.004). A PWS less than or equal to 1% of the body surface area (OR = 9.05; 95% CI, 1.42-57.57; p = 0.020) and 5-10 sessions of previous PDL treatment (OR = 8.06; 95% CI, 2.01-32.33; p = 0.003) were positive influential factors for PDL-resistant PWS.
CONCLUSIONS: We propose that at least 4 HMME-PDT sessions could be recommended for patients with PDL-resistant PWSs, and the improvement after the first HMME-PDT session was the most evident compared with that after each subsequent treatment. Moreover, greater erythema and a greater number of previous PDL session were associated with poor HMME-PDT efficacy.