A Systematic Review on the Effectiveness of Photodynamic Therapy in the Treatment of Oral Precancerous Lesions and Oral Cancers

Sep 30, 2026

Photodynamic therapy (PDT) is a minimally invasive option for oral potentially malignant disorders and cancers, providing targeted treatment with limited side effects. The review synthesizes studies using 5-aminolevulinic acid (ALA)-PDT, extracting lesion type, session frequency, light power density, adverse effects, and recurrence. Results from 11 studies show OVH and OEL often respond with fewer than seven weekly sessions, while oral leukoplakia performs better with twice-weekly treatment. Methylene blue-mediated PDT improved oral lichen planus without reported adverse effects. Overall efficacy and safety are supported, but inconsistencies remain regarding optimal laser power density and recurrence risk, highlighting the need for individualized protocols and standardized guidelines.

LanguageEnglish

CategoryHealthcare

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Systematic Review A Systematic Review on the Effectiveness of Photodynamic Therapy in the Treatment of Oral Precancerous Lesions and Oral Cancers Nishath Sayed Abdul Department of OMFS and Diagnostic Sciences, Faculty of Oral Pathology, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia Submitted: 04‑Aug‑2025 Revised: 06‑Aug‑2025 Accepted: 19‑Aug‑2025 Published: 17‑Dec‑2025 Abstract Photodynamic therapy (PDT) has gained prominence as a minimally invasive treatment for various oral precancerous lesions and cancers, offering a targeted therapeutic approach with limited side effects. Among the commonly used photosensitizers, 5‑aminolevulinic acid (ALA) has shown promise when activated by specific light sources. A comprehensive review of the literature was conducted, focusing on studies that utilized ALA‑PDT for oral potentially malignant disorders (OPMDs) and early‑stage oral cancers. Key data were extracted, including lesion type, number of treatment sessions, light power density, side effects, and recurrence rates. Comparative analysis was performed to identify consistent trendsand variations across different lesion types. The review included data from 11 studies. Oral verrucous hyperplasia (OVH) and oral erythroleukoplakia (OEL) were found to respond favorably to fewer than seven weekly ALA‑PDT sessions. Oral leukoplakia demonstrated better outcomes with twice‑weekly treatments. Additionally, methylene blue‑mediated PDT showed marked improvement in oral lichen planus, with no reported adverse effects. While overall efficacy and safety were confirmed, inconsistencies emerged regarding optimal laser power density and recurrence risks, underscoring the need for individualized protocols. In conclusion, ALA-PDT appears to be an effective and well-tolerated treatment for several oral precancerous lesions. Lesion-specific characteristics and treatment parameters playa critical role in achieving complete regression. Standardized guidelines and further research are warranted to refine PDT protocols and enhance clinical outcomes. Keywords: 5‑Aminolevulinic acid, lesion regression, oral verrucous hyperplasia, oral cancer, oral erythroleukoplakia, oral leukoplakia, oral lichen planus, photodynamic therapy, recurrence Introduction Oral cancer continues to pose a health challenge globally, with significant public rising incidence rates and profound implications for patient morbidity and quality of life. Oral potentially malignant disorders (OPMDs), such as leukoplakia anderythroplakia, are considered precursors to malignancy and require timely and effective management to prevent malignant transformation.[1] Conventional treatment options—surgery, chemotherapy, and radiotherapy—are the mainstay therapies for both OPMDs and established oral cancers. However, these modalities often carry the risk of functional compromise, anatomical distortion, | Access this article online | | | --- | --- | | Quick Response Code:
| Website: [https://journals.lww.com/jpbs](https://journals.lww.com/jpbs) | | | DOI: 10.4103/jpbs.jpbs_1361_25 | and patient discomfort, especially in the context of the oral cavity’s complex anatomy. In this backdrop, photodynamic therapy (PDT) has emerged as a promising minimally invasive therapeutic approach.[2] PDT involves the administration of a photosensitizing agent that selectively accumulates in dysplastic or malignant cells. Upon activation by a specific wavelength of light in the Address for correspondence: Dr. Nishath Sayed Abdul. Department of OMFS and Diagnostic Sciences, Faculty of Oral Pathology, Riyadh Elm University, Riyadh, 11681, Kingdom of Saudi Arabia. Email: [nishathsayed@riyadh.edu.sa](nishathsayed@riyadh.edu.sa) This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License (CC BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work canno

FAQs

What is the purpose of this systematic review?

To critically assess the clinical effectiveness of photodynamic therapy in achieving complete remission of oral precancerous lesions and to inform future treatment strategies.

Which photosensitizer and light-based approach were emphasized in the included studies?

The review focused on studies using 5-aminolevulinic acid (ALA)-PDT activated by specific light sources, and also reported on methylene blue-mediated PDT.

How did treatment frequency and lesion type relate to outcomes?

OVH and OEL showed favorable responses with fewer than seven weekly ALA-PDT sessions, while oral leukoplakia showed better outcomes with twice-weekly treatments.

Sep 30, 2026

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