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Photodynamic therapy superior to cryosurgery for thin actinic keratoses

Photodynamic therapy offered better chances of complete lesion clearance than cryotherapy at 3 months after treatment for thin actinic keratoses on the face and scalp, according to study findings.

Researchers assessed 13 randomized trials that used aminolevulinic acid hydrochloride or methyl aminolevulinate hydrochloride as stabilizers and included 10 or more participants, identifying 4 trials deemed eligible for meta-analysis. Data quality was assessed using Jadad scoring system, and a random-effects model was used for pooled data analysis.

The meta-analysis comprised 641 participants and included 2,174 actinic keratoses (AKs) treated with cryotherapy and 2,170 AKs treated with photodynamic therapy (PDT).

Among the six articles that compared PDT with cryotherapy, two reported rates of complete clearance of lesions on the face and scalp that significantly favored PDT compared with cryotherapy at 12 weeks and 1 year.

Of five studies that provided the investigators’ cosmetic assessments, only two had any statistical significance favoring PDT over cryotherapy; however, in the eight studies that provided patients’ cosmetic assessments, PDT was favored predominantly over cryotherapy and topical imiquimod, according to the researchers.