Aim

Oral leukoplakia is globally the most prevalent malignant disorder of the oral mucosa and its clinical management remains a challenge. A systematic review was carried out to determine the clinical efficacy of photodynamic therapy mediated by topical 5-aminolevulinic acid as an alternative for chemoprevention in the different clinical forms of oral leukoplakia.

Materials and methods

Using MeSH terms, an exhaustive search was carried out in different digital databases of clinical trials published in English in the last 30 years on the use of photodynamic therapy mediated by topical 5-aminolevulinic acid as a photosensitizer, and low-intensity laser radiation or LED light as possible lighting sources.

Results

The systematized review using PRISMA guidelines showed an efficacy of 88.6% for this mode of phototherapy in the management of oral leukoplakias, based on 60.7% of complete response and 27.9% of partial response. In addition, the effect size was larger in homogeneous clinical forms with dysplastic changes, regardless of the type of light source. There was an 11.4% of absence of response, but the evidence used in this analysis was moderate.

Conclusion

Photodynamic therapy mediated by topical 5-aminolevulinic acid seems to be a useful alternative in the onco-preventive management of oral leukoplakia lesions. However, it is recommendable to perform controlled and randomized clinical trials with homogeneous methodologies that allow the generation of a meta-analysis with a high level of evidence.