SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Cancer Molecular Targets and Therapeutics
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1528314
Umbrella Review of Photodynamic Therapy for Cancer: Efficacy, Safety, and Clinical Applications
Provisionally accepted
- 1Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
- 2Shandong Provincial Hospital, Jinan, Shandong Province, China
- 3Shandong Provincial Third Hospital, Jinan, Shandong Province, China
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Background: Photodynamic therapy (PDT) can target cancers, while causing little damage to surrounding healthy tissues.Objective: To systematically evaluate the efficacy, safety, and clinical applications of PDT across cancer types.Methods: PubMed, 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.There is weak evidence that PDT combined with biliary stenting improves overall survival (OS) relative to 1 AE Adverse events ALA 5-Aminolevulinic acid AMSTAR Assessment of multiple systematic reviews BCC Basal cell carcinoma CCA Corrected Covered Area CI Confidence interval DL DerSimonian-Laird HR Hazard ratio MAL Methyl aminolevulinate NMIBC Non-muscle invasive bladder cancer PI Prediction interval ROS Reactive oxygen species RR Relative risk SCC Squamous cell carcinoma OR Odds ratio OS Overall survival RCT Randomized controlled trials WMD Weighted mean difference YAG-AFL Erbium: yttrium-aluminum-garnet ablative factional laser 5-FU 5-Fluorouracil 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. Conclusion: PDT shows potential benefits in several cancers, especially for nonmelanoma 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.
Keywords: Photodynamic therapy, Cancer, Meta-analysis, Umbrella review, photosensitizer
Received: 14 Nov 2024; Accepted: 03 Jul 2025.
Copyright: © 2025 Chen, Li, Li and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hanhan Chen, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
Zhen Zhang, Shandong Provincial Third Hospital, Jinan, Shandong Province, China
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