310P - Laser and PDT for the oral leukoplakia

Background

Leukoplakia is a oral pathology characterized by an increased risk for malignant transformation. Histopathology of leukoplakia can disclose hyperkeratosis with dysplasia or carcinoma or hyperkeratosis or parakeratosis without dysplasia. Existence of the different treatment options not decrease the the rates of recurrence up to 35%.

Methods

Totally 40 patients with OL (homogenous type - 35 cases; verrucous type - 4 case; erythroleukoplakia - one case) were recruited for the study. In a period September 2017 – may 2019 all the patients were screened, and only those patients with clinically, and histologically proven OL was included under the study. All the patients had the history of using tobacco in smoking or smokeless form (Nasvay). 1470 nm diode laser ablation was done under 5- ALA induced spectroscopy. In case of detection a pathological fluorescence after the session treatment was accompanied with PDT treatment. 10% ALA emulsion (0.1 g of 99.9% ALA powder in 1 ml liquid paraffin) was used freshly just before the start of the therapy to avoid deterioration of the emulsion on contact with light. Diode lamp (Vostok -1, Uzbekistan) with power - 5 W, wavelength -630 ± 5 nm was used as the light source. Total dose delivered per session was 100 J/cm 2 . The therapy was performed in a one session. All patients were recalled at 4 weeks after completion of the last session of modified therapy. Lesion response was characterized as follows: Complete response (CR), ; partial response (PR), reduction at least 20% in diameter; no response (NR). The patients were followed-up for a period of 1 year.

Results

One month (4 weeks) after 1470 nm diode laser ablation + ALA-PDT, the response was evaluated based on clinical examination. CR was obtained in 35 out of 40 patients; PR in 5 out of 40 patients; and NR no patient. During the follow-up, no changes in the clinical appearance of the treated lesions were recorded. There was no recurrence of the lesion noted in CR cases. During the incubation period of 3 h after ALA application, the patients did not have any adverse effect in the form of pain, redness or discomfort. Patients did not have any other side effects.

Conclusions

Our observations suggest that topical ALA mediated PDT with laser ablation is a promising means of treating OL.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Tashkent medical academy.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.