Comparison of clinical outcomes of oral erythroleukoplakia treated with photodynamic therapy using either light-emitting diode or laser light

Background and Objectives: Topical 5-aminolevulinic acid-mediated photodynamic therapy (topical ALA-PDT) using a 635-nm light-emitting diode (LED) light is an effective treatment modality for oral verrucous hyperplasia. This study tested whether topical ALA-PDT using either the LED or laser light was also an effective treatment modality for oral erythroleukoplakia (OEL) lesions. Study Design/Materials and Methods: In this prospective but non-randomized study, 20 OEL lesions were treated with topical ALA-PDT using the 635-nm LED light and 26 OEL lesions were treated with topical ALA-PDT using the 635-nm laser light. The difference in clinical outcomes was compared between the two groups by Fisher exact test. Results: We found that the 20 LED light-treated OEL lesions showed complete response (CR) in 17 and partial response (PR) in 3. The 17 CR OEL lesions required an average of 3.7 (range, 2-7) treatments of ALA-PDT to achieve CR of the lesions. The 26 laser light-treated OEL lesions showed CR in 25 and PR in 1. The 25 CR OEL lesions needed an average of 3.3 (range, 2-6) treatments of ALA-PDT to achieve CR of the lesions. There was no significant difference in PDT outcomes between the 20 LED light-treated and 26 laser light-treated OEL lesions (P = 0.303). When the 42 CR OEL lesions were pooled together, we found that smaller lesions (greatest diameter <1.5 cm) and lesions with thinner surface keratin (keratin layer ≤30 mm) needed significantly fewer mean treatment number of PDT to achieve a CR than the larger lesions (P = 0.000) and lesions with thicker surface keratin (P = 0.000), respectively. Conclusions: Topical ALA-PDT using either the LED or laser light is an effective treatment modality for OEL lesions. There is no significant difference in clinical outcomes of OEL lesions treated with PDT using either the LED or laser light.