Table 1_Umbrella review of photodynamic therapy for cancer: efficacy, safety, and clinical applications.docx

BackgroundPhotodynamic therapy (PDT) can target cancers, while causing little damage to surrounding healthy tissues
ObjectiveTo systematically evaluate the efficacy, safety, and clinical applications of PDT across cancer types.
MethodsPubMed, EMBASE, Cochrane Library, and Web of Science were searched to April 7, 2024 for systematic reviews and meta-analyses of PDT in patients with cancer. Quality assessment was performed using Assessment of Multiple Systematic Reviews 2, overlapping meta-analyses were handled using Corrected Covered Area, and data re-synthesized using a random-effects model.
ResultsEighteen publications met the inclusion criteria. There is weak evidence that PDT combined with biliary stenting improves overall survival (OS) relative to stenting alone (hazard ratio (HR) 0.49, 95% confidence interval (CI) 0.33–0.73), while PDT with chemotherapy improved OS (HR 0.36, 95% CI 0.15–0.87), without increasing adverse events. Weak evidence indicated lower clearance and complete response rates and higher recurrence rates of non-melanoma skin cancers, particularly basal cell carcinoma (BCC), after PDT than following surgery. In squamous cell carcinoma (SCC), complete response rates (relative risk 2.75; 95% CI 2.19–3.45) were higher for laser-assisted than conventional PDT; PDT provided better cosmetic outcomes than other therapies. Single-arm meta-analyses demonstrated some efficacy of PDT for treating cutaneous metastatic SCC, oral SCC, prostate cancer, and bladder cancer.
ConclusionPDT shows potential benefits in several cancers, especially for non-melanoma skin cancer and unresectable cholangiocarcinoma. While newer PDT strategies may improve outcomes, more high-quality trials are needed to confirm its role across cancer types.
Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024538243, identifier CRD42024538243.

背景：光动力疗法（Photodynamic therapy, PDT）可靶向作用于癌细胞，同时对周围健康组织造成的损伤极小。
研究目的：系统评估光动力疗法在不同癌种中的疗效、安全性及临床应用价值。
研究方法：检索PubMed、EMBASE、Cochrane Library及Web of Science数据库截至2024年4月7日的关于癌症患者光动力疗法的系统评价与荟萃分析文献。采用多系统评价评估工具2（Assessment of Multiple Systematic Reviews 2, AMSTAR2）进行文献质量评价，使用校正覆盖面积法（Corrected Covered Area）处理重叠的荟萃分析内容，并采用随机效应模型进行数据再合成。
研究结果：最终共有18篇文献符合纳入标准。有弱证据表明，光动力疗法联合胆道支架置入相较单纯支架置入可改善患者总生存期（overall survival, OS），风险比（hazard ratio, HR）为0.49，95%置信区间（confidence interval, CI）为0.33~0.73；光动力疗法联合化疗亦可改善患者总生存期（HR=0.36，95%CI：0.15~0.87），且未增加不良事件发生率。另有弱证据显示，非黑色素瘤皮肤癌（尤其是基底细胞癌，basal cell carcinoma, BCC）患者接受光动力疗法后的肿瘤清除率、完全缓解率低于手术治疗，而复发率更高。在鳞状细胞癌（squamous cell carcinoma, SCC）中，激光辅助光动力疗法的完全缓解率（相对风险2.75；95%CI：2.19~3.45）高于传统光动力疗法，且光动力疗法的美容效果优于其他治疗方式。单臂荟萃分析结果显示，光动力疗法对皮肤转移性鳞状细胞癌、口腔鳞状细胞癌、前列腺癌及膀胱癌均具有一定治疗效果。
结论：光动力疗法在多种癌症中展现出潜在治疗价值，尤其适用于非黑色素瘤皮肤癌及不可切除的胆管癌。尽管新型光动力疗法策略可改善治疗结局，但仍需开展更多高质量临床试验以明确其在各类癌种中的临床应用价值。
系统评价注册信息：https://www.crd.york.ac.uk/PROSPERO/view/CRD42024538243，注册编号CRD42024538243。