Methylaminolaevulinate-based photodynamic therapy of Bowen's disease and squamous cell carcinoma.
Br J Dermatol
; 159(1): 137-44, 2008 Jul.
Article
em En
| MEDLINE
| ID: mdl-18489606
ABSTRACT
BACKGROUND:
Photodynamic therapy (PDT) with methylaminolaevulinate (MAL) is an approved noninvasive treatment option for actinic keratosis and Bowen's disease (BD), two precursors of invasive squamous cell carcinoma (SCC).OBJECTIVES:
To assess efficacy, prognostic features, tolerability and cosmetic outcome of MAL-PDT for the treatment of BD and SCC.METHODS:
In total, 112 biopsy-proven lesions of BD and SCC in 55 subjects were treated in an outpatient setting. MAL cream (160 mg g(-1)) was applied for 3 h prior to illumination with a light-emitting diode source (wavelength range 635 +/- 18 nm; light dose 37 J cm(-2)). A second MAL-PDT session was given 7 days later. Complete response rate at 3 months after the last treatment, recurrence rate at the 24-month follow-up, and cosmetic outcome were recorded.RESULTS:
The overall complete response rates were 73.2% at 3 months and 53.6% at 2 years. Clinical thickness, atypia and lesion depth were significant predictors of the response at 3 months when using a univariate analysis (P < 0.001). A multivariate logistic regression model, with robust variance estimation, showed that cell atypia was the only statistically significant independent predictor of the treatment outcome at 3 months.CONCLUSIONS:
MAL-PDT may represent a valuable, effective and well tolerated treatment option with good cosmetic outcome for superficial, well-differentiated (Broders' scores I and II) BD and microinvasive SCC. In contrast, its use for superficial SCCs with a microinvasive histological pattern and for nodular, invasive lesions, particularly if poorly differentiated keratinocytes are present (Broders' scores III and IV), should be avoided.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fotoquimioterapia
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Neoplasias Cutâneas
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Doença de Bowen
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Carcinoma de Células Escamosas
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Fármacos Fotossensibilizantes
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Ácido Aminolevulínico
Tipo de estudo:
Prognostic_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article