Photodynamic therapy of basal cell carcinoma and factors affecting the response to treatment

Abstract

Objective To investigate efficacy and safety of photodynamic therapy on basal cell carcinomas.Methods Twenty three cases of basal cell carcinomas were given with photosensitizer 5-amino acid (ALA) ketone spreading on skin lesions.Reddish illumination was taken at 4h later with energy density at 100 J/cm2,40 min/time,and weekly for a total of 4 weeks; and 2 year followup in the study was evaluated recurrence retrospectively.Results Among twenty three patients with basal cell carcinomas,15 were cured(65.22％),5 partially (21.74％) remitted,and 3 ineffective (13.04％),with the efficiency 86.96％.None of the resolved lesions recurred during the 6-month follow-up period,and 3 cases were recurred within 1 year (20％).Repeated ALA-photodynamic therapy (PDT) treatment,recurred lesions were completely resolved.There were no additional recurrences after 2 year.ALA-PDT was well tolerated,and adverse effects were limited to mild local pain and erythema.Only three patients were complained of erythema and edema.Complete response rate was higher in younger patients (t =-2.94,P ＜0.01) and those with smaller lesions (t =-5.92,P ＜ 0.01).Superficial type had also significant higher response rate (x2 =27.17,P ＜ 0.01).Conclusions The application of photodynamic therapy in treatment of basal cell carcinoma is effective with less painfulness,non-invasiveness,and without side effect.It demonstrated a good efficacy and satisfactory cosmetic outcomes. Key words: Photochemotherapy ; Carcinoma, basal cell/therapy; Aminolevulinic acid/therapeutic use; Photosensitizing agents/therapeutic use ; Treatment outcome