An Analysis of Laser Therapy for the Treatment of Nonmelanoma Skin Cancer

Abstract

BACKGROUND Skin cancer remains the most prevalent type of cancer in the United States, and its burden on the health care system remains substantial. Standard treatments such as cryosurgery, electrodessication and curettage, topical and photodynamic therapies, and surgical excision including Mohs micrographic surgery are not without inherent morbidity, including risk of bleeding, infection, and scar. OBJECTIVE Lasers may be an alternative for treatment of nonmelanoma skin cancer, and this paper reviews this therapeutic option. METHODS A comprehensive search in the Cochrane Library, MEDLINE, and PUBMED databases was performed to identify relevant literature investigating the role of laser therapy in the treatment of nonmelanoma skin cancer. RESULTS New literature regarding laser treatment of nonmelanoma skin cancer is emerging, demonstrating promising clinical outcomes. The greatest efficacy has been seen with vascular-selective and ablative lasers in the treatment of basal cell carcinomas. Some success has been reported for laser treatment of squamous cell carcinoma, but data are less convincing. In summary, laser therapy offers an alternative treatment option for nonmelanoma skin cancer; however, its clinical efficacy is variable and, at this time, remains less than currently accepted standards of care. CONCLUSION Further studies are needed to optimize parameters, determine maximum efficacy, and provide long-term follow-up.

Updates on the Management of Non-Melanoma Skin Cancer (NMSC)

“…Upon light absorption, the PPIX then undergoes excitation, resulting in production of oxygen free radicals, ultimately leading to cancer cell death. [ 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 ]. PDT has shown to be effective in treating superficial BCC, SCCis, and actinic keratosis (AK) with excellent cosmesis, though, it is currently not recommended for invasive SCC and aggressive BCC subtypes such as basosquamous or morphoeic infiltrating types [ 110 , 111 ].…”

“…There are four major laser types used in the treatment of skin cancers: solid-state, diode, dye, and gas lasers [ 157 ]. A recent review article by Soleymani et al discusses the different types of laser treatments in detail [ 158 ]. This study demonstrated that vascular targeting pulse dye lasers (PDL) have shown promising results in different studies with a complete clinical response in up to 95% of patients; nevertheless, poor results were also seen.…”

“…CO 2 lasers allow very thin tissue ablation in the range of 20 µm with each pass [ 159 , 160 , 161 , 162 , 163 ]. Several studies have shown a different efficacy of CO 2 lasers for treatment of BCC with 85–100% cure rates, excellent cosmetic outcomes, and minimal complications [ 158 ]. Lasers have been less commonly used and studied for the treatment of SCC, with only a handful of studies demonstrating the efficacy of CO2 lasers in treatment of SCCis.…”

Papillary Endothelial Hyperplasia (Masson Tumor) of the Hand. Surgical and Pathological Consideration from Seven Cases Using New Vascular Markers

“…An unusual case with rapid growth was recently reported by Corni et al, [8] but they did not observe recurrence or complications at a 6 months followup. Furthermore, though 15% of recurrence rate was noted in recent literature; [8,28] all of these cases had a benign natural history.…”

Update on the topical and systemic treatment in non-melanoma skin cancers

“…A legújabb adatok szerint alacsony kockázatú basaliomák esetén jól kiválogatott esetekben lehet terápiás alternatíva a széndioxid lézer egyéb kezeléssel (pl. fotodinámiás terápia) kombinálva (17)(18)(19).…”