Long‐term outcomes of Aminolevulinic Acid Photodynamic Therapy for Treatment of Recalcitrant Laryngeal Premalignant Lesions

xlomafota13 shared this article with you from Inoreader Long‐term outcomes of Aminolevulinic Acid Photodynamic Therapy for Treatment of Recalcitrant Laryngeal Premalignant Lesions Via Clinical Otolaryngology Abstract Objective Assess long-term outcomes of ALA-PDT in treating recalcitrant laryngeal leukoplakia. Study design Retrospective Case-Control. Methods We reviewed all laryngeal leukoplakia patients treated with ALA-PDT compared with angiolytic laser treatment alone (585nm PDL or 532nm KTP laser) from 2000 to 2019. Patients with laryngeal cancer (or a history of laryngeal cancer), leukoplakia previously treated with radiation and no pathologic report were excluded. Patient demographics, procedure details, and outcomes were examined including histopathologic diagnosis, procedures performed, ALA usage, recurrence of leukoplakia, and the development of cancer. Results We identified 132 patients with laryngeal leukoplakia: 42 were treated with ALA-PDT and 90 were treated with an angiolytic laser alone (Laser group). The proportion of cases of high-grade dysplasia was 57.1% in the ALA-PDT group compared to 32.2% in the Laser group. In high-grade dysplasia cases, there was a statistically significant better recurrence-free survival (RFS) at 12 months and 60 months in those who underwent ALA-PDT 71.4% and 7.1% vs Laser 25% and 0% (P=0.01). However, for overall group there was no difference in RFS (P=0.25). Voice outcomes (Patient subjective report) improved or were stable in 75% of subjects with no serious side effects reported. Conclusion ALA-PDT for recalcitrant and high-grade dysplasia is highly effective with improved recurrence-free survival compared to laser alone. ALA-PDT may be an appropriate therapy in patients who have failed prior angiolytic laser alone. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.