Photodynamic therapy in the management of basal cell carcinoma: Retrospective evaluation of outcome

Publication date: Available online 22 April 2017
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Waseem Jerjes, Zaid Hamdoon, Colin Hopper
IntroductionPhotodynamic therapy (PDT) is a relatively new method of treating various kinds of pathologies. In this retrospective study, a total of 148 patients with basal cell carcinoma (BCC) were treated with surface illumination methyl aminolevulinate − photodynamic therapy (MAL-PDT) or meta-tetrahydroxyphenylchlorin (mTHPC-PDT). Comparisons with the clinical features, rate of recurrence and overall outcome were made.Materials and methodsSurface illumination PDT was offered under local or general anaesthesia. For thin BCCs, the 16% strength cream (MAL) was applied topically 3hours prior to tissue illumination. A single-channel 628nm diode laser was used for illumination and light was delivered at 100J/cm² per site. For thick BCCs, 0.05mg/kg mTHPC was administered intravenously prior to tissue illumination. A single-channel 652nm diode laser was used for illumination and light was delivered at 20J/cm² per site. Lesion response evaluation was carried out according to RECIST.ResultsThe MAL-PDT sub-group included 86 patients with 127 thin BCCs; 80 patients had complete response (CR) after one round of treatment. The mTHPC-PDT sub-group included 62 patients with 116 thick BCCs; 60 patients had complete response after one round of treatment. Statistically significant factors associated with complete response to MAL-PDT included superficial BCC histotype (P <0.001), ≤0.5mm tumour thickness (P <0.001) and lack of ulceration (P <0.001). While for the mTHPC-PDT sub-group, both superficial and nodular types responded significantly better than invasive type (P<0.001); the lack of ulceration was insignificant factor in achieving complete responseConclusionPDT achieved high efficacy in the treatment of basal cell carcinomas with greatly reduced morbidity and disfigurement. The technique is simple, can commonly be carried out in outpatient clinics, and is highly acceptable to patients.



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