Your browser doesn't support javascript.
loading
A feasibility study of microwave therapy for precancerous actinic keratosis.
Jackson, D N; Hogarth, F J; Sutherland, D; Holmes, E M; Donnan, P T; Proby, C M.
Affiliation
  • Jackson DN; Department of Dermatology, NHS Tayside, Ninewells Hospital, Dundee, DD1 9SY, Scotland, UK.
  • Hogarth FJ; Tayside Clinical Trials Unit, University of Dundee, DD1 9SY, Scotland, UK.
  • Sutherland D; Clinical Research Centre, NHS Tayside, Ninewells Hospital, Dundee, DD1 9SY, Scotland, UK.
  • Holmes EM; Dundee Epidemiology and Biostatistics Unit, Population Health and Genomics, School of Medicine, University of Dundee, DD1 9SY, Scotland, UK.
  • Donnan PT; Dundee Epidemiology and Biostatistics Unit, Population Health and Genomics, School of Medicine, University of Dundee, DD1 9SY, Scotland, UK.
  • Proby CM; Department of Dermatology, NHS Tayside, Ninewells Hospital, Dundee, DD1 9SY, Scotland, UK.
Br J Dermatol ; 183(2): 222-230, 2020 08.
Article in En | MEDLINE | ID: mdl-32030723
ABSTRACT

BACKGROUND:

Actinic keratosis (AK) is a common premalignant skin lesion that can progress to cutaneous squamous cell carcinoma (cSCC). Microwave therapy is an established cancer treatment and has been used for plantar viral warts.

OBJECTIVES:

To evaluate the efficacy and feasibility of microwave as a treatment for AK.

METHODS:

Stage I was a dose-setting study, in which seven participants had the dielectric properties of 12 thick and 22 thin AKs assessed for optimization of the microwave dose used for treatment in Stage II. Stage II was a randomized, internally controlled trial evaluating 179 AKs in 11 patients (93 treated, 86 untreated controls) on the scalp/forehead or dorsal hand. Participants received one treatment initially and a repeat treatment to unresolved AKs at week 4. The response was assessed at six visits over 4 months. The primary outcome was partial or complete resolution of the treated AKs.

RESULTS:

A significantly higher proportion of treated AK areas responded than untreated (90% vs. 15%; P < 0·001). Thin AKs were more responsive than thick AKs. The site did not affect efficacy. Pain was severe, but brief (80% reported pain lasting 'a few seconds only'). Adverse effects were minimal (erythema, n = 6; flaking, n = 3; itch, n = 3). All participants who would chose microwave therapy over their current treatment cited the shorter discomfort period.

CONCLUSIONS:

Microwave therapy is a portable, safe and effective treatment for AK. An easy-to-deliver, acceptable therapy for AK is attractive as a prevention strategy. While these results are promising, a larger randomized controlled trial is needed against an effective comparator to confirm clinical efficacy and patient acceptability. What is already known about this topic? Actinic keratoses (AKs) are common precancerous skin lesions. Successful treatment of AK can prevent cutaneous squamous cell carcinoma (cSCC). Most topical therapies for AK require repeated application over weeks and drive local skin inflammation, leading to poor compliance. An easy-to-deliver and effective treatment for AK, suitable for use in primary care, could reduce cSCC. What does this study add? Microwave therapy is a feasible, effective treatment for AK. Ninety per cent of treated AKs showed full or partial resolution at 120 days post-treatment. Microwave therapy was painful, but the pain was short-lived (seconds) and this short discomfort period was cited as the main reason that microwave was preferred to their current treatment.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Skin Neoplasms / Carcinoma, Squamous Cell / Keratosis, Actinic Type of study: Clinical_trials Limits: Humans Language: En Journal: Br J Dermatol Year: 2020 Document type: Article Affiliation country: Reino Unido

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Skin Neoplasms / Carcinoma, Squamous Cell / Keratosis, Actinic Type of study: Clinical_trials Limits: Humans Language: En Journal: Br J Dermatol Year: 2020 Document type: Article Affiliation country: Reino Unido