Effect of the combination of diode laser ablation with photodynamic therapy for oral leukoplakia with epithelial dysplasia: a retrospective study.

OBJECTIVE: Photodynamic therapy (PDT) has become a promising treatment option for oral leukoplakia (OLK), but its clinical efficacy and efficiency remain limited. The aim of this study was to assess the effect of combining diode laser ablation with PDT for OLK with epithelial dysplasia. METHODS: Forty-one patients diagnosed with OLK with epithelial dysplasia (mild, moderate, severe) were recruited in the study. All patients received one session of laser ablation, followed by 1-3 sessions of aminolevulinic acid (ALA) -PDT using a 635 nm laser at 100 mW/cm2 power density at a dosage of 100 J/cm2. The treatment effect was evaluated 1 month after therapy and every 3 months thereafter for a total of 12 months. RESULTS: All patients responded to the combined therapy. The complete and partial response rates were 61.0% and 39.0%, respectively. Lesion size ≤200 mm2 was associated with complete response (P < .05). During the 12-month follow-up, recurrence occurred in 13 patients. The cumulative rate of malignant transformation was 7.3%. CONCLUSIONS: Diode laser ablation combined with PDT is an effective and high-efficiency treatment modality for OLK with epithelial dysplasia, particularly for lesion size ≤200 mm2. However, recurrence and malignant transformation still exist after therapy.