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In vivo fluorescence kinetics and photodynamic therapy efficacy of delta-aminolevulinic acid-induced porphyrins in basal cell carcinomas and actinic keratoses; implications for optimization of photodynamic therapy.

Abstract
Photodynamic therapy (PDT) with topical d-aminolevulinic acid (ALA) has become a therapeutic option of growing interest for superficial non-melanoma precancerous and malignant lesions. After application of ALA, in situ conversion to endogenous porphyrins is accomplished in a gradual manner. Therefore, the determination of fluorescence kinetics and spatial distribution in vivo versus time is a crucial point for the success of ALA-PDT. Seventeen basal cell carcinomas (BCC) and 20 actinic keratoses (AK) were enrolled in this study. In 5 BCC and 4 AK, in vivo fluorescence kinetics were performed over 24 hrs and for the remaining lesions between 2 and 7 hrs after ALA application. In vivo spatial and quantitative detection of the fluorescence intensity versus time showed considerable variations among tumors of the same type, so light irradiation was performed according to patient individualities. Both BCC and AK showed maximal median fluorescence intensity at 4-6.5 hrs post-application. In the present study, a high cure rate was proven after topical ALA-PDT (70.6% in BCC and 85% in AK). The results of fluorescence studies suggest that optimum irradiation time for BCC is approximately 3.5-5 hrs and for AK 5 hrs after ALA application, when relative maximal fluorescence intensity in correlation with fluorescence selectivity on the lesion, is obtained.
AuthorsM Stefanidou, A Tosca, G Themelis, E Vazgiouraki, C Balas
JournalEuropean journal of dermatology : EJD (Eur J Dermatol) 2000 Jul-Aug Vol. 10 Issue 5 Pg. 351-6 ISSN: 1167-1122 [Print] France
PMID10882942 (Publication Type: Journal Article)
Chemical References
  • Photosensitizing Agents
  • Porphyrins
  • Aminolevulinic Acid
Topics
  • Administration, Topical
  • Aged
  • Aminolevulinic Acid (administration & dosage, pharmacokinetics, therapeutic use)
  • Carcinoma, Basal Cell (drug therapy)
  • Female
  • Fluorescence
  • Head and Neck Neoplasms (drug therapy)
  • Humans
  • Keratosis (drug therapy)
  • Kinetics
  • Male
  • Photochemotherapy
  • Photosensitizing Agents (administration & dosage, pharmacokinetics, therapeutic use)
  • Porphyrins (metabolism)
  • Precancerous Conditions (drug therapy)
  • Skin Neoplasms (drug therapy)
  • Time Factors
  • Treatment Outcome

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