Abstract | BACKGROUND: OBJECTIVES: To investigate the efficacy and safety of PDT using MAL for BCCs defined as 'difficult to treat', i.e. large lesions, in the H-zone, or in patients at high risk of surgical complications. METHODS: This was a prospective, multicentre, noncomparative study. Patients were assessed 3, 12 and 24 months after the last PDT treatment. One hundred and two patients with 'difficult-to-treat' BCC were treated with MAL PDT, using 160 mg g(-1) cream and 75 J cm(-2) red light (570-670 nm), after lesion preparation and 3 h of cream exposure. Results Ninety-five patients with 148 lesions were included in the per protocol analysis. The histologically confirmed lesion complete response rate at 3 months was 89% (131 of 148). At 12 months, 10 lesions had reappeared, and therefore the cumulative treatment failure rate was 18% (27 of 148). At 24 months, an additional nine lesions had reappeared, resulting in a cumulative treatment failure rate of 24% (36 of 148). The estimated sustained lesion complete response rate (assessed using a time-to-event approach) was 90% at 3 months, 84% at 12 months and 78% at 24 months. Overall cosmetic outcome was judged as excellent or good in 79% and 84% of the patients at 12 and 24 months, respectively. Follow-up is continuing for up to 5 years. CONCLUSIONS: MAL PDT is an attractive option for 'difficult-to-treat' BCC. Because of the excellent cosmetic results, the treatment is particularly well suited for lesions that would otherwise require extensive surgical procedures.
|
Authors | C Vinciullo, T Elliott, D Francis, K Gebauer, L Spelman, R Nguyen, W Weightman, A Sheridan, C Reid, D Czarnecki, D Murrell |
Journal | The British journal of dermatology
(Br J Dermatol)
Vol. 152
Issue 4
Pg. 765-72
(Apr 2005)
ISSN: 0007-0963 [Print] England |
PMID | 15840111
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Photosensitizing Agents
- methyl 5-aminolevulinate
- Aminolevulinic Acid
|
Topics |
- Administration, Topical
- Adult
- Aged
- Aged, 80 and over
- Aminolevulinic Acid
(administration & dosage, adverse effects, analogs & derivatives)
- Carcinoma, Basal Cell
(drug therapy, pathology)
- Female
- Humans
- Male
- Middle Aged
- Patient Satisfaction
- Photochemotherapy
(adverse effects, methods)
- Photosensitizing Agents
(administration & dosage, adverse effects)
- Prospective Studies
- Risk Factors
- Skin Neoplasms
(drug therapy, pathology)
- Time Factors
- Treatment Failure
- Treatment Outcome
|