Waseem Jerjes1, Zaid Hamdoon2, Colin Hopper3. 1. UCL Department of Surgery, London, UK. Electronic address: waseem_wk1@yahoo.co.uk. 2. UCLH Head and Neck Centre, London, UK. 3. UCL Department of Surgery, London, UK; UCLH Head and Neck Centre, London, UK; Unit of Oral and Maxillofacial Surgery, UCL Eastman Dental Institute, London, UK.
Abstract
INTRODUCTION: Photodynamic 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 METHODS: Surface illumination PDT was offered under local or general anaesthesia. For thin BCCs, the 16% strength cream (MAL) was applied topically 3h 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. RESULTS: The 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 response. CONCLUSION: PDT 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.
INTRODUCTION: Photodynamic 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 METHODS: Surface illumination PDT was offered under local or general anaesthesia. For thin BCCs, the 16% strength cream (MAL) was applied topically 3h 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. RESULTS: The 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 response. CONCLUSION: PDT 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.
Authors: E V Gubarkova; F I Feldchtein; E V Zagaynova; S V Gamayunov; M A Sirotkina; E S Sedova; S S Kuznetsov; A A Moiseev; L A Matveev; V Y Zaitsev; D A Karashtin; G V Gelikonov; L Pires; A Vitkin; N D Gladkova Journal: Sci Rep Date: 2019-12-10 Impact factor: 4.379