Abstract
Non-melanoma skin cancer (NMSC) is traditionally treated with surgical excision. Non-surgical methods such as cryotherapy and topical chemotherapeutics, amongst other treatments, are other options. Actinic keratosis (AKs) are considered precancerous lesions that eventually may progress to squamous cell carcinoma (SCC). Photodynamic therapy (PDT) offers an effective treatment for AKs, and is also effective for superficial basal cell carcinoma (BCC). Nodular BCC and Bowen’s disease (SCC in situ) have shown acceptable response rates with PDT, although recurrence rates are higher for these two NMSC subtypes. Methylaminolevulinate (MAL) PDT is a more effective treatment option than 5-aminolevulinic acid (ALA) PDT for nodular BCC. Several studies have shown that PDT results in superior cosmetic outcomes compared to surgical treatment. PDT is overall well-tolerated, with pain being the most common side effect.
Highlights
Non-melanoma skin cancer (NMSC) is the most common cancer of white-skinned individuals worldwide
Actinic keratoses (AKs) are lesions considered to be on a spectrum of clinical and histologic abnormalities that can progress to squamous cell carcinoma (SCC) [2]
Photodynamic therapy (PDT) offers an attractive alternative to surgical treatment of NMSC, as well as an alternative to non-surgical treatments such as cryotherapy and 5-fluorouracil
Summary
Non-melanoma skin cancer (NMSC) is the most common cancer of white-skinned individuals worldwide. Actinic keratoses (AKs) are lesions considered to be on a spectrum of clinical and histologic abnormalities that can progress to squamous cell carcinoma (SCC) [2]. The organ transplant population is at a increased risk of NMSC, quantified as 65 to 250-fold for SCC, and as. Several treatment modalities exist for AK, BCC, and SCC. The mainstay of treatment remains surgery via simple excision or Mohs Micrographic Surgery (MMS) for BCC and SCC. In the US, FDA approval for PDT is limited to treatment of AKs, whereas in the European Union (EU) and elsewhere worldwide, approval expands to the treatment of BCC and SCC in situ. The main aims of this review are to discuss the mechanism of PDT, and to address the clinical use of PDT for treatment of NMSC, including efficacy and tolerability
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