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This study compared four cPDT illumination protocols to evaluate efficacy and tolerability in head-region AK. In 67 patients, pain and phototoxic skin-reaction intensity were recorded during and after treatment; clearance was assessed at 12 weeks and 24 weeks, with retreatment for incomplete clearance. Lower fluence rates reduced pain and reaction severity without lowering overall clearance or recurrence/new AK rates.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/impact-of-light-dose-and-fluence-rate-on-the-efficacy-and-tolerability-of-topical-5-ala-photodynamic-therapy-for-actinickeratoses-research-results/329916/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/impact-of-light-dose-and-fluence-rate-on-the-efficacy-and-tolerability-of-topical-5-ala-photodynamic-therapy-for-actinickeratoses-research-results/329916.png","ImageObject",300,407,{"name":92,"@type":93},"Ophelia","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the primary goal of comparing the four cPDT illumination protocols?","Question",{"text":112,"@type":113},"To compare efficacy and tolerability of four different cPDT illumination protocols for actinic keratoses in the head region.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were treatment settings varied in the study?",{"text":117,"@type":113},"Patients received PDT on comparable target areas using: standard light dose/standard fluence rate, standard light dose/halved fluence rate, halved light dose/standard fluence rate, and halved light dose/halved fluence rate.",{"name":119,"@type":110,"acceptedAnswer":120},"Did lowering fluence rate or light dose affect treatment effectiveness?",{"text":121,"@type":113},"No. Overall clearance of AK, clearance of target lesions at 3 months, and recurrence or new AK at 6 months did not differ between protocols.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},329916,1790186968,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},7971461741311,"https://ap-avatar.wpscdn.com/avatar/74000253aff267980c6?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779345379180704826","DOI: 10.1111/jdv.20527  \nO R IG I N A L A R T I C L E  \nImpact of light dose and fluence rate on the efficacy and tolerability of topical 5-ALA photodynamic therapy for actinickeratoses: A randomized, controlled, observer-blinded intrapatient comparison study  \nAdrian Tanew1  | Robin Ristl2 | Hannes Trattner3 | Valentin Hacker3 | Bettina Kroyer2 | Sonja Radakovic3   \n1Private Practice, Vienna, Austria 2Center for Medical Data Science, Medical University of Vienna, Vienna, Austria 3Department of Dermatology, Medical University of Vienna, Vienna, Austria  \nCorrespondence  \nSonja Radakovic, Department of Dermatology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna A-1090, Austria.  \nEmail: [sonja.radakovic@meduniwien.ac.at](sonja.radakovic@meduniwien.ac.at)  \nFunding information  \nBiofrontera Bioscience Germany  \nAbstract  \nBackground: Conventional photodynamic therapy (cPDT) is an effective treatment option for field cancerization and multiple actinic keratoses (AK). The main side effect of cPDT is pain during illumination which in severe cases might necessitate early termination of treatment. Modification of treatment parameters such as light dose and fluence rate is a promising approach to mitigate PDT-associated pain. Objectives: The aim of this study was to compare the efficacy and tolerability of four different cPDT illumination protocols in the treatment of AK in the head region. Methods: Prospective, investigator-blinded, within-patient study on 67 patients with multiple AK in the head region. PDT treatment was performed on comparable target areas with four different settings of illumination: (A) standard light dose and standard fluence rate, (B) standard light dose and halved fluence rate, (C) halved standard light dose and standard fluence rate and (D) halved standard light dose and halved fluence rate. Pain and the intensity of the phototoxic skin reaction was recorded during and after illumination. The clearance rate of the target areas and target lesions was assessed at 12 weeks after PDT. Target areas with incomplete clearance were retreated, those with complete clearance were reassessed at 24 weeks after PDT.  \nResults: The mean and maximum pain level during illumination was significantly decreased at the lower fluence rates. The phototoxic skin reaction was most pronounced with the standard illumination setting. The overall clearance rate of AK and the clearance rate of the target lesions at 3 months after PDT as well as the number of recurrent or new AK at 6 months after PDT did not differ between four treatment protocols.  \nConclusions: Reduction of the fluence rate and/or light dose was associated with less PDT-induced pain and/or shorter exposures times without compromising the therapeutic efficacy of cPDT for AK in the head region.  \n\n| Linked article: H. Christian Wulf et al. J Eur Acad Dermatol Venereol 2025;39:1376–1377. [https://doi.org/10.1111/jdv.20791](https://doi.org/10.1111/jdv.20791). |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.\u003Cbr>© 2024 The Author(s). Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology. |\n\n[1460](1460 | wileyonlinelibrary.com/journal/jdv)[ |](1460 | wileyonlinelibrary.com/journal/jdv)[ wileyonlinelibrary.com/journal/jdv](1460 | wileyonlinelibrary.com/journal/jdv) J Eur Acad Dermatol Venereol. 2025;39:1460–1467.  \nINTRODUCTION  \nPhotodynamic therapy (PDT) has been successfully used for treating actinic keratosis (AK) and non-melanoma skin cancer since 1990.1,2 In addition, treatment of field cancerization with PDT has in recent years increasingly moved into the centre of interest as an effective measure with an excelle","cbCaiihhcGM7Tj3M","https://ap.wps.com/l/cbCaiihhcGM7Tj3M","pdf",285708,"English","# Abstract\n## Background and objectives\n## Methods\n## Results\n## Conclusions\n# Introduction\n## PDT rationale and pain limitations\n## Rationale for modifying light dose and fluence rate\n# Patients and methods\n## Study design and participants","[{\"question\":\"What was the primary goal of comparing the four cPDT illumination protocols?\",\"answer\":\"To compare efficacy and tolerability of four different cPDT illumination protocols for actinic keratoses in the head region.\"},{\"question\":\"How were treatment settings varied in the study?\",\"answer\":\"Patients received PDT on comparable target areas using: standard light dose/standard fluence rate, standard light dose/halved fluence rate, halved light dose/standard fluence rate, and halved light dose/halved fluence rate.\"},{\"question\":\"Did lowering fluence rate or light dose affect treatment effectiveness?\",\"answer\":\"No. Overall clearance of AK, clearance of target lesions at 3 months, and recurrence or new AK at 6 months did not differ between protocols.\"}]","Impact of light dose and fluence rate on the efficacy and tolerability of topical 5-ALA photodynamic therapy for actinickeratoses - research results | PDF",1789986141]