Data di Pubblicazione:
2002
Citazione:
Systematic review of randomized trials for the treatment of oral leukoplakia / G. Lodi, A. Sardella, C. Bez, F. Demarosi, A. Carrassi. - In: EUROPEAN JOURNAL OF DENTAL EDUCATION. - ISSN 1396-5883. - 66:8(2002), pp. 896-902.
Abstract:
Oral leukoplakia is a relatively common oral lesion that, in a varying proportion
of cases, undergoes malignant transformation. The aim of this review was to
assess the effectiveness of treatments for leukoplakia. Randomized controlled
trials (RCTs) enrolling patients with a diagnosis of oral leukoplakia were
identified by searching biomedical databases, hand-searching relevant oral
medicine journals, and contacting oral medicine experts through a European
mailing list. The methodological quality of included studies was assessed on the
basis of the method of allocation concealment, blindness of the study, and loss
of participants. Data were analyzed by calculating relative risk. Malignant
transformation of leukoplakia, demonstrated by histopathological examination, was
the main outcome considered. Secondary outcomes included clinical resolution of
the lesion and variation in dysplasia severity. Six RCTs were included in the
review. Vitamin A and retinoids were tested in four RCTs; the other agents tested
were bleomycin, mixed tea, and beta carotene. Malignant transformation was
recorded in just two studies: none of the treatments tested showed a benefit when
compared with placebo. Treatment with beta carotene and vitamin A or retinoids
was associated with better rates of clinical remission, compared with placebo or
absence of treatment. Whenever reported, a high rate of relapse was a common
finding. Side effects of variable severity were often described; however,
interventions were well accepted by patients since drop-out rates were similar
between treatment and control groups. It is noteworthy that the possible
effectiveness of surgical interventions, including laser therapy and cryotherapy,
has apparently never been studied by means of an RCT. To date, in conclusion,
there is no evidence of effective treatment in preventing malignant
transformation of leukoplakia. Treatments may be effective in the resolution of
lesion; however, relapses and adverse effects are common.
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
G. Lodi, A. Sardella, C. Bez, F. Demarosi, A. Carrassi
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