Laser therapy decreases oral leukoplakia recurrence and boosts patient comfort: a network meta-analysis and systematic review

作者：Rui Luo, Yanan Wang, Ruixin Li, Yanan Ma, Haitao Chen, Jian Zhang, Jun Shen · 发表于：BMC Oral Health · 年份：2024 · DOI：10.1186/s12903-024-04179-9 · 被引用次数：9 · 研究领域：Oral Health Pathology and Treatment、Oral health in cancer treatment、Laser Applications in Dentistry and Medicine

Abstract Background Oral leukoplakia (OLK) is a prevalent precancerous lesion with limited non-pharmacological treatment options. Surgery and various lasers are the mainstay of treatment; however, their relative efficacy and optimal choice remain unclear. This first network meta-analysis compared the effects of different lasers and surgical excision on post-treatment recurrence and comfort in OLK patients. Methods We searched four databases for relevant randomized controlled trials (RCTs) up to April 2023. The primary outcome was post-treatment recurrence, and secondary outcomes included intraoperative hemorrhage and postoperative pain scores. The Cochrane Risk of Bias tool was used to assess the study quality. Meta-analysis and network meta-analysis were employed to determine efficacy and identify the optimal intervention. Results A total of 11 RCTs including 917 patients and 1138 lesions were included. Er,Cr:YSGG laser treatment showed significantly lower recurrence rates compared to CO 2 laser (OR: 0.04; 95% CI: 0.01–0.18), CO 2 laser with margin extension (OR: 0.06; 95% CI: 0.01–0.60), Er:YAG laser (OR: 0.10; 95% CI: 0.03–0.37), electrocautery (OR: 0.03; 95% CI: 0.00–0.18), and standard care (OR: 0.08; 95% CI: 0.02–0.33). Er,Cr:YSGG laser also ranked the best for reducing recurrence, followed by standard care and CO 2 laser combined with photodynamic therapy (PDT). Er:YAG and Er:Cr:YSGG lasers minimized bleeding and pain, respectively. None of the interventions caused sev...