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Optimized photodynamic therapy with systemic photosensitizer following debulking technique for nonmelanoma skin cancers.

AbstractBACKGROUND: The thickness and depth of invasion of skin tumors may be limiting factors for topical photosensitizer-based photodynamic therapy (PDT). The use of PDT with systemic photosensitizer needs to be further explored as a modality of treatment for nonmelanoma skin cancer (NMSC). OBJECTIVE: The objective was to present six patients with multiple, nodular, and/or pigmented NMSC treated successfully with purified hematoporphyrin derivative (PHD) and PDT using prior debulking. METHODS: After 24 hours of systemic PHD (1.5 mg/kg), 12 lesions of NMSC were selected for PHD-PDT alone and 6 nodular/elevated lesions for PHD-PDT following a debulking procedure. The tumor area was illuminated in one single-dose session of 300 J/cm(2), at an intensity range of 130 to 150 mW/cm(2), with a 630-nm-wavelength diode laser. RESULTS: The prior curettage provided significant reduction in volume and/or pigmentation of lesions. After the session of PHD-PDT with prior curettage and additional topical 20% ALA-PDT in two lesions or PHD-PDT alone, 83% (5/6) of lesions and 58% (7/12) of lesions, respectively, maintained a complete clinical response, 22.2+/-8.9 months of follow-up. CONCLUSIONS: The combination of prior debulking with systemic agents-PDT appears to be a good option for multiple, pigmented, and/or nodular lesions of NMSC and can allow the improvement of clinical results.
AuthorsCacilda S Souza, Ana B S Neves, Lília A B Felício, Juliana Ferreira, Cristina Kurachi, Vanderlei S Bagnato (Affiliation: Division of Dermatology of the School of Medicine of Ribeirão Preto, University of São Paulo, São Carlos, São Paulo, Brazil. cssouza at fmrp.usp.br)
JournalDermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (Dermatol Surg) Vol. 33 Issue 2 Pg. 194-8 (Feb 2007) ISSN: 1076-0512 United States
PMID17300605 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Photosensitizing Agents
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Facial Dermatoses (drug therapy, surgery)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Photochemotherapy (methods)
  • Photosensitizing Agents (therapeutic use)
  • Skin Neoplasms (drug therapy, surgery)
  • Treatment Outcome