Long-term efficacy data for daylight-PDT

INTRODUCTION: Conventional photodynamic therapy (c-PDT) is an established successful treatment for non-melanoma skin cancers (NMSC). Daylight PDT (DL-PDT) was introduced to overcome the main inconveniencies associated with c-PDT such as pain during illumination and long clinic visits. DL-PDT was shown to have similar short-term efficacy to c-PDT for the treatment of mild/moderate actinic keratosis (AKs) but it is associated with better tolerability. Since AKs tend to regress and reoccur over time, data on long-term efficacy of DL-PDT become crucial. EVIDENCE ACQUISITION: We performed a systematic review search up to February 2018 of available studies on DL-PDT long-term efficacy using the MEDLINE database and made a manual search of selected references. EVIDENCE SYNTHESIS: Most current studies on DL-PDT have limited follow-up periods of 3 to 6 months. Only 2 randomized, intraindividual studies provided efficacy data on AK treatment at 12 month-follow-up and supported the long-term efficacy of this novel treatment modality showing a low recurrence rate, varying from 8.7% to 13%. Current evidences for other NMSCs are limited and efficacy seems to be not as good as for AK. CONCLUSIONS: DL-PDT is a very promising treatment for mild to moderate AKs of the face and scalp. Efficacy outcomes of DL-PDT are similar to those of c-PDT in the short-term. Additional studies are required to increase our knowledge on DL-PDT long-term efficacy, as limited data are currently available.