Photodynamic therapy with methyl-5-aminolevulinate for basal cell carcinoma: A systematic review and meta-analysis.
Photodiagnosis Photodyn Ther
; 29: 101667, 2020 Mar.
Article
em En
| MEDLINE
| ID: mdl-31978564
ABSTRACT
BACKGROUND:
Basal cell carcinoma (BCC) is the most common type of non-melanoma skin cancer worldwide. Methyl-5-aminolevulinate (MAL) photodynamic therapy (PDT) is an effective and acceptable treatment for BCC. The purpose of this analysis was to compare the benefit and tolerability of MAL-PDT with other modalities for the treatment of BCC.METHODS:
PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched from inception until 5 August 2019. Eligible studies were prospective and retrospective clinical trials of MAL-PDT for superficial and nodular BCC. At least one of the following outcomes were reported complete response (CR) at 3 months and sustained at 12 months; recurrence at 12 months and sustained at 5 years; cosmetic outcome at ≥ 3 months; adverse events.RESULTS:
From 427 search results, 11 articles including seven randomized controlled trials (1339 patients; 1568 lesions) and one retrospective study (108 lesions) were eligible. CR was inferior with MAL-PDT versus surgery (3 months Risk Ratio [RR] 0.93, 95 % confidence interval [CI] 0.89-0.97, p = 0.002; 12 months RR 0.90, 95 % CI 0.85-0.95, p = 0.0002). Moreover, MAL-PDT had higher 12 months recurrence rate (RR 10.43, 95 % CI 1.98-55.03, p = 0.006) and more toxicities (RR 2.12, 95 % CI 1.46-3.09, p < 0.0001) in comparison with surgery. However, MAL-PDT cosmesis was superior to excisional surgery (RR 1.99, 95 % CI 1.50-2.63, p < 0.00001). Additionally, MAL-PDT was associated with similar CR in comparison with 5-aminolaevulinic acid (ALA)-PDT and ALA nanoemulsion (BF-200 ALA)-PDT, but had higher recurrence rate at 12 months and worse cosmesis compared with BF-200 ALA-PDT, even though the differences were not statistically significant.CONCLUSION:
MAL-PDT might not be the best first-line treatment option for BCC, although cosmetic outcome could be good-to-excellent.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fotoquimioterapia
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Neoplasias Cutâneas
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Carcinoma Basocelular
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Fármacos Fotossensibilizantes
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Ácido Aminolevulínico
Tipo de estudo:
Clinical_trials
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Observational_studies
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Risk_factors_studies
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Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Photodiagnosis Photodyn Ther
Ano de publicação:
2020
Tipo de documento:
Article