Comparison of efficacy, adverse effects and costs between 20% ALA-PDT and 10% ALA-PDT for the treatment of actinic keratosis in Chinese patients

Abstract Background 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) is a reliable treatment for actinic keratosis (AK), and the concentration of ALA for this treatment is 20% in most studies, but it was found that 10% ALA could achieve similar outcome during clinical practice while reducing the costs. However, there are limited reports comparing the efficacy and the safety of 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) with different ALA doses. Objectives This study was designed to compare the efficacy, the adverse effects and the costs of 10% and 20% ALA-PDT for AK. Methods We reviewed the records of patients treated with ALA-PDT in our department between January 1, 2012, and April 30, 2017, the efficacy, the adverse effects were recorded, and the costs were analyzed. Follow-up data were collected until April 30, 2018. Results A total of 59 AK patients’ records were analyzed for efficacy, adverse events, recurrence and costs. There was no statistical difference between 10% ALA-PDT and 20% ALA-PDT in terms of efficacy and adverse events. In the 10% ALA group, there was one recurrence out of 34 patients and in the 20% group there were none. The costs calculated per lesion treated was significantly lower in the 10% ALA group than 20% ALA group. Conclusions 10% ALA-PDT has similar efficacy and adverse effects as 20% ALA-PDT but lower costs. Taken together, this supports the use of 10% ALA-PDT in clinical practice.