Is the benefit of sequential 5-fluorouracil and daylight photodynamic therapy versus daylight photodynamic therapy alone sustained over time? – 12-month follow-up of a randomized controlled trial
Background: Since recurrences and new AKs commonly are observed after treatment long-term effects of field-directed therapies for AKs are crucial. Thus, we evaluated the 6- and 12-month efficacy and satisfaction of sequential topical 5-fluorouracil (5-FU) and daylight PDT (dPDT) with dPDT alone. Met...
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Elsevier
2025-02-01
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| Series: | Photodiagnosis and Photodynamic Therapy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1572100024004812 |
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| author | Stine Regin Wiegell Gabriella Fredman Flemming Andersen Peter Bjerring Uwe Paasch Merete Haedersdal |
| author_facet | Stine Regin Wiegell Gabriella Fredman Flemming Andersen Peter Bjerring Uwe Paasch Merete Haedersdal |
| author_sort | Stine Regin Wiegell |
| collection | DOAJ |
| description | Background: Since recurrences and new AKs commonly are observed after treatment long-term effects of field-directed therapies for AKs are crucial. Thus, we evaluated the 6- and 12-month efficacy and satisfaction of sequential topical 5-fluorouracil (5-FU) and daylight PDT (dPDT) with dPDT alone. Methods: In a randomized intra-individual study patients with multiple AKs in the face and scalp were treated with 4 % 5-fluorouracil cream twice daily for 7 days on one side of the scalp/face, followed by dPDT on both sides. Lesion clearance rate, lesion recurrence rate and number of new lesions were evaluated at 6- and 12-month after treatment. Results: 58/60 completed 6-month and 55/60 completed 12-month follow-up. Pre-treatment with topical 5-FU improved the long-term efficacy of dPDT, especially for moderately thick AKs, with a lesion clearance of 72 % at 12-month compared to 48 % after dPDT alone (p = 0.017). The recurrence rate at 12-month was 15 % for combination treatment and 20 % for dPDT alone (0.042). Most patients were highly satisfied with both treatments. Conclusions: Sequential treatment with short-term topical 5-FU followed by dPDT maintained a higher complete lesion clearance than dPDT alone at both 6- and 12-month follow-ups, with fewer new AKs developing after combination therapy. |
| format | Article |
| id | doaj-art-cc6fd31a54e24690ad4d0ce46b2d048a |
| institution | Kabale University |
| issn | 1572-1000 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Photodiagnosis and Photodynamic Therapy |
| spelling | doaj-art-cc6fd31a54e24690ad4d0ce46b2d048a2025-02-01T04:11:44ZengElsevierPhotodiagnosis and Photodynamic Therapy1572-10002025-02-0151104445Is the benefit of sequential 5-fluorouracil and daylight photodynamic therapy versus daylight photodynamic therapy alone sustained over time? – 12-month follow-up of a randomized controlled trialStine Regin Wiegell0Gabriella Fredman1Flemming Andersen2Peter Bjerring3Uwe Paasch4Merete Haedersdal5Department of Dermatology, Copenhagen University Hospital Bispebjerg, Nielsine Nielsens Vej 9, 2400 Copenhagen NV, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen NV, Denmark; Department of Dermatology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Corresponding author.Department of Dermatology, Copenhagen University Hospital Bispebjerg, Nielsine Nielsens Vej 9, 2400 Copenhagen NV, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen NV, DenmarkDepartment of Dermatology, Private Hospital Mølholm, Brummersvej 1, 7100 Vejle, DenmarkDepartment of Dermatology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, DenmarkDepartment of Dermatology, Venereology and Allergy, University of Leipzig, Philipp-Rosenthal-Straße, 04103 Leipzig, GermanyDepartment of Dermatology, Copenhagen University Hospital Bispebjerg, Nielsine Nielsens Vej 9, 2400 Copenhagen NV, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen NV, DenmarkBackground: Since recurrences and new AKs commonly are observed after treatment long-term effects of field-directed therapies for AKs are crucial. Thus, we evaluated the 6- and 12-month efficacy and satisfaction of sequential topical 5-fluorouracil (5-FU) and daylight PDT (dPDT) with dPDT alone. Methods: In a randomized intra-individual study patients with multiple AKs in the face and scalp were treated with 4 % 5-fluorouracil cream twice daily for 7 days on one side of the scalp/face, followed by dPDT on both sides. Lesion clearance rate, lesion recurrence rate and number of new lesions were evaluated at 6- and 12-month after treatment. Results: 58/60 completed 6-month and 55/60 completed 12-month follow-up. Pre-treatment with topical 5-FU improved the long-term efficacy of dPDT, especially for moderately thick AKs, with a lesion clearance of 72 % at 12-month compared to 48 % after dPDT alone (p = 0.017). The recurrence rate at 12-month was 15 % for combination treatment and 20 % for dPDT alone (0.042). Most patients were highly satisfied with both treatments. Conclusions: Sequential treatment with short-term topical 5-FU followed by dPDT maintained a higher complete lesion clearance than dPDT alone at both 6- and 12-month follow-ups, with fewer new AKs developing after combination therapy.http://www.sciencedirect.com/science/article/pii/S1572100024004812Actinic keratosesDaylight photodynamic therapy5-fluorouracilCombination therapyLong-term follow-up |
| spellingShingle | Stine Regin Wiegell Gabriella Fredman Flemming Andersen Peter Bjerring Uwe Paasch Merete Haedersdal Is the benefit of sequential 5-fluorouracil and daylight photodynamic therapy versus daylight photodynamic therapy alone sustained over time? – 12-month follow-up of a randomized controlled trial Photodiagnosis and Photodynamic Therapy Actinic keratoses Daylight photodynamic therapy 5-fluorouracil Combination therapy Long-term follow-up |
| title | Is the benefit of sequential 5-fluorouracil and daylight photodynamic therapy versus daylight photodynamic therapy alone sustained over time? – 12-month follow-up of a randomized controlled trial |
| title_full | Is the benefit of sequential 5-fluorouracil and daylight photodynamic therapy versus daylight photodynamic therapy alone sustained over time? – 12-month follow-up of a randomized controlled trial |
| title_fullStr | Is the benefit of sequential 5-fluorouracil and daylight photodynamic therapy versus daylight photodynamic therapy alone sustained over time? – 12-month follow-up of a randomized controlled trial |
| title_full_unstemmed | Is the benefit of sequential 5-fluorouracil and daylight photodynamic therapy versus daylight photodynamic therapy alone sustained over time? – 12-month follow-up of a randomized controlled trial |
| title_short | Is the benefit of sequential 5-fluorouracil and daylight photodynamic therapy versus daylight photodynamic therapy alone sustained over time? – 12-month follow-up of a randomized controlled trial |
| title_sort | is the benefit of sequential 5 fluorouracil and daylight photodynamic therapy versus daylight photodynamic therapy alone sustained over time 12 month follow up of a randomized controlled trial |
| topic | Actinic keratoses Daylight photodynamic therapy 5-fluorouracil Combination therapy Long-term follow-up |
| url | http://www.sciencedirect.com/science/article/pii/S1572100024004812 |
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