Efficacy and safety of topical ALA-PDT in the treatment of EMPD.

BACKGROUND: Photodynamic therapy (PDT) is a successful treatment for non-melanoma skin cancers in clinical practice. More and more doctors use PDT to cure the patients with skin cancer, especially in the elder. The purpose of this study was to evaluate the efficacy and safety of topical PDT using aminolevulinic acid (5-ALA) in the treatment of Extramammary Paget's disease (EMPD) and its role in surgical improvements. METHODS: A total of 38 cases were included in this study. Lesions were located in the scrotum and the penis. Thirty-one cases had surgical resection of the lesions followed by ALA-PDT (combination of PDT and surgery group). Seven cases received ALA-PDT without receiving surgical resection because the surgery is extremely difficult or the patients refused surgery (simple PDT group). Each tumor lesion was irradiated with 120J/cm(2) using a 635-nm laser for 15min. A total of 3 times of assisted ALA-PDT was applied after surgery. RESULTS: In the combination group, there was no recurrence in 6 months after treatment. In another group, recurrence occurred in 1 case in 6 months. All patients were able to complete the treatment protocol, with well cosmetic results and no moderate adverse reactions. CONCLUSIONS: As an assistive therapy after tumor resection, ALA-PDT can reduce the excision range of the tumor lesions and will play more important role in the treatment of EMPD.

Efficacy of topical ALA-PDT combined with excision in the treatment of skin malignant tumor.

BACKGROUND: Photodynamic therapy (PDT) is a successful treatment for non-melanoma skin cancers in clinical practice. In China, more and more doctors use PDT to cure the patients with skin cancer, especially in the elder. The purpose of this study was to evaluate the efficacy of topical PDT using aminolevulinic acid (5-ALA) combined with excision in the treatment of skin malignant tumor and its role in surgical improvements. METHODS: A total of 58 cases including 32 cases of BCC, 13 cases of Bowen's disease, 8 cases of Paget's disease and 5 cases of SCC were included in this study. All cases were treated with topical ALA-PDT after surgery. Each tumor region was irradiated with 120 J/cm(2) using a 635-nm laser for 15 min. A total of 3 times of assisted ALA-PDT was applied after surgery. RESULTS: There was no recurrence in 6 months after treatment. Only 5 cases of Paget's disease and 2 cases of SCC experienced disease recurrence in 1 year. All patients were able to complete the treatment protocol, with well cosmetic results and no moderate adverse reactions. CONCLUSIONS: As an assistive therapy after tumor resection, ALA-PDT can reduce the excision range of the tumor lesions. However, its role in the reduction of recurrence rate remains to be further investigated.