Abstract：
Despite phototherapy (in the form of photodynamic therapy (PDT)-mediated oxidative stress) being utilized in the management of oral potentially malignant disorders (OPMDs), the evidence of certainty remains unclear. Hence, this systematic review and meta-analysis (PROSPERO # CRD42021218748) is aimed to evaluate the clinical efficacy of PDT-induced oxidative stress in OPMDs METHODS: PubMed, Embase, Web of Science, Scopus, and Cochrane Library databases were searched without restriction of language or year of publication. In addition, gray literature was searched and a manual search was performed. Two independent reviewers screened all the studies, assessing data extraction, risk of bias and certainty of evidence. A narrative synthesis was carried out. For the meta-analysis, random effects were considered to determine the prevalence of a total and a partial remission (PR) of oral potentially malignant disorders (OPMDs). The certainty of evidence was explored using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
Twenty-three studies were included in the qualitative and quantitative syntheses. A total of 880 patients were included (564 males; 218 females) with an age range between 24 and 89-years-old. The results showed the prevalence of the total and partial remissions respectively for the following OPMLs: actinic cheilitis (AC): 69.9% and 2.4%; oral leukoplakia (OL): 44% and 36.9%; oral verrucous hyperplasia (OVH): 98.5%; oral erythroleukoplakia (OEL): 92.1% and 7.9%. The prevalence of no remission of OL was 18.8%.
PDT demonstrated significant results in clinical remission of OPMDs and most of the eligible studies have shown a total or a partial remission of the included lesions, but at a low or a very low certainty of evidence. Hence, further clinical studies with robust methodology are warranted to offer further validated data. Also, further evidence is required to understand further the mechanism of PDT-induced oxidative stress.
Twenty-three studies were included in the qualitative and quantitative syntheses. A total of 880 patients were included (564 males; 218 females) with an age range between 24 and 89-years-old. The results showed the prevalence of the total and partial remissions respectively for the following OPMLs: actinic cheilitis (AC): 69.9% and 2.4%; oral leukoplakia (OL): 44% and 36.9%; oral verrucous hyperplasia (OVH): 98.5%; oral erythroleukoplakia (OEL): 92.1% and 7.9%. The prevalence of no remission of OL was 18.8%.
PDT demonstrated significant results in clinical remission of OPMDs and most of the eligible studies have shown a total or a partial remission of the included lesions, but at a low or a very low certainty of evidence. Hence, further clinical studies with robust methodology are warranted to offer further validated data. Also, further evidence is required to understand further the mechanism of PDT-induced oxidative stress.
摘要：
尽管光疗（以光动力疗法（PDT）介导的氧化应激的形式）被用于治疗口腔潜在恶性疾病（OPMD），确定性的证据仍不清楚。因此，本系统综述和荟萃分析（PROSPERO#CRD42021218748）旨在评估PDT诱导的氧化应激在OPMDs中的临床疗效。方法：PubMed，Embase,WebofScience,Scopus,和Cochrane图书馆数据库的搜索不受语言或出版年份的限制。此外,检索灰色文献,并进行人工检索.两名独立审稿人筛选了所有研究，评估数据提取，证据的偏见和确定性风险。进行了叙事综合。对于荟萃分析，我们考虑了随机效应来确定口腔潜在恶性疾病(OPMDs)的全部和部分缓解(PR)的患病率.使用建议分级来探索证据的确定性，评估,开发和评估(等级)方法。
23项研究被纳入定性和定量综合。共纳入880例患者（男性564例，女性218例），年龄在24至89岁之间。结果显示以下OPML的总缓解率和部分缓解率分别为：光化性唇炎（AC）：69.9％和2.4％；口腔白斑（OL）：44％和36.9％；口腔疣状增生（OVH）：98.5％；口腔红斑（OEL）：92.1％和7.9％。OL未缓解的患病率为18.8%。
PDT在OPMD的临床缓解中显示出显著的结果，并且大多数符合条件的研究表明所包括的病变完全或部分缓解。但是证据的确定性很低或很低。因此，需要采用可靠方法的进一步临床研究,以提供进一步验证的数据.此外，需要进一步的证据来进一步了解PDT诱导的氧化应激的机制。
23项研究被纳入定性和定量综合。共纳入880例患者（男性564例，女性218例），年龄在24至89岁之间。结果显示以下OPML的总缓解率和部分缓解率分别为：光化性唇炎（AC）：69.9％和2.4％；口腔白斑（OL）：44％和36.9％；口腔疣状增生（OVH）：98.5％；口腔红斑（OEL）：92.1％和7.9％。OL未缓解的患病率为18.8%。
PDT在OPMD的临床缓解中显示出显著的结果，并且大多数符合条件的研究表明所包括的病变完全或部分缓解。但是证据的确定性很低或很低。因此，需要采用可靠方法的进一步临床研究,以提供进一步验证的数据.此外，需要进一步的证据来进一步了解PDT诱导的氧化应激的机制。
