Bowen’s disease, solar keratoses and superficial basal cell carcinomas treated by photodynamic therapy using a large-field incoherent light source
✍ Scribed by S. Varma; H. Wilson; H.A. Kurwa; B. Gambles; C. Charman; A.D. Pearse; D. Taylor; A.V. Anstey
- Publisher
- John Wiley and Sons
- Year
- 2001
- Tongue
- English
- Weight
- 382 KB
- Volume
- 144
- Category
- Article
- ISSN
- 0007-0963
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✦ Synopsis
Background:
Photodynamic therapy (pdt) has not yet been demonstrated to be superior to conventional treatment in the treatment of superficial skin cancers and premalignant skin conditions. a limitation for pdt is the absence to date of a light source suitable for the treatment of larger lesions or 'field changes' where several lesions are present on one anatomical site.
Objectives:
To investigate the safety and efficacy of a large field light source, the waldmann pdt 1200, in the treatment of bowen's disease (bd), superficial basal cell carcinomas (bccs) and solar keratoses (sks).
Methods:
After application of 5-aminolaevulinic acid for 4-6 h, each lesion was irradiated with 105 j cm-2 of incoherent red light centred on 640 nm. eighty-eight patients with 239 lesions were recruited.
Results:
Within two treatments, 88% of bd lesions, 95% of bccs and 99% of sks showed complete clinical clearance. at 12 months the complete response rates were 69% for bd, 82% for bcc and 72% for sk.
Conclusions:
This study confirms that pdt is a useful treatment and that selected superficial bccs and sks respond well to pdt. the pdt 1200 light source proved capable of treating multiple lesions amounting to a 'field change' and also lesions up to 10 cm in diameter within an acceptable treatment time. thus far, pdt has failed to become established as a routine treatment for small premalignant and malignant skin lesions as it has not proved superior to simple cheaper conventional therapies such as cryotherapy, curettage and cautery, topical chemotherapy with 5-fluorouracil, or surgery. however, pdt has become established as a treatment for selected cases in some centres. this study suggests a role for pdt in the treatment of large premalignancies, superficial bccs and field change where existing treatments may be problematic.