Er:<scp>YAG</scp> ablative fractional laser‐primed photodynamic therapy with methyl aminolevulinate as an alternative treatment option for patients with thin nodular basal cell carcinoma: 12‐month follow‐up results of a randomized, prospective, comparative trial

Choi, Seung-Hwan; Kim, K.H.; Song, Ki‐Hoon

doi:10.1111/jdv.13453

Cited by 50 publications

(46 citation statements)

References 22 publications

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“…Observed side‐effects are similar to the known side‐effects of CO 2 laser and PDT in monotherapy . Previous studies about FL + PDT found a frequency of side‐effects comparable to those in this study, except for increased crusting (84–100%) and pigmentary changes (66.7–74%) …”

Section: Discussionsupporting

confidence: 86%

“…This, however, is no explanation for FL + PDT being perceived as less painful as intrapatient comparison was made. Previous studies using lidocaine–prilocaine 5% anaesthetic cream considered FL + PDT as painful as PDT, but observed higher mean VAS‐scores (42.2–48.6 mm) compared to ours (10.0–20.33 mm) …”

Section: Discussioncontrasting

confidence: 77%

“…observed a low 12‐month histological efficacy in FL + PDT (63% CR), which was not significantly different from the one in PDT (56% CR) in 32 high‐risk nBCC. On the other hand, a study of Choi et al . found significantly better efficacy after one session of FL + PDT (78.9% CR) compared to two sessions of PDT (22.2% CR) during a follow‐up period of 12 months in 42 thin nBCC.…”

Section: Discussionmentioning

confidence: 92%

“…Several preclinical studies showed facilitated accumulation of topically applied drugs . Clinical studies demonstrated enhanced lesion response when CO 2 or erbium‐doped yttrium aluminium garnet (Er:YAG) laser preceded PDT compared to PDT or laser alone . Ablative laser‐assisted PDT is considered to offer good tolerability, satisfactory aesthetics and might provide other advantages such as reduced photosensitizer incubation time …”

Section: Introductionmentioning

confidence: 99%

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Laser‐assisted photodynamic therapy for superficial basal cell carcinoma and Bowen's disease: a randomized intrapatient comparison between a continuous and a fractional ablative CO₂ laser mode

Genouw

Verheire

Ongenae

et al. 2018

Acad Dermatol Venereol

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Results in this pilot study support the promising role of laser-assisted PDT. Both treatment arms demonstrated the same efficacy as well as comparable side-effects and aesthetics. PDT illumination was significantly less painful in the FL + PDT group, suggesting a preference for FL + PDT. The authors recommend further investigation with a larger sample size, a subgroup analysis between sBCC and BD and comparison of different treatment protocols before one technique could be preferred to another.

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Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Laser‐assisted photodynamic therapy for superficial basal cell carcinoma and Bowen's disease: a randomized intrapatient comparison between a continuous and a fractional ablative CO₂ laser mode

Genouw

Verheire

Ongenae

et al. 2018

Acad Dermatol Venereol

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“…Longterm data regarding the safety and effectiveness of pulsed dye or Er:YAG lasers for treatment of BCC are lacking. 74,93,104 …”

Section: Laser Therapymentioning

confidence: 99%

Guidelines of care for the management of basal cell carcinoma

Baum¹,

Bordeaux²,

Brown³

et al. 2018

Journal of the American Academy of Dermatology

326

219

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Basal cell carcinoma (BCC) is the most common form of human cancer, with a continually increasing annual incidence in the United States. When diagnosed early, the majority of BCCs are readily treated with office-based therapy, which is highly curative. In these evidence-based guidelines of care, we provide recommendations for the management of patients with BCC, as well as an in-depth review of the best available literature in support of these recommendations. We discuss biopsy techniques for a clinically suspicious lesion and offer recommendations for the histopathologic interpretation of BCC. In the absence of a formal staging system, the best available stratification based on risk for recurrence is reviewed. With regard to treatment, we provide recommendations on treatment modalities along a broad therapeutic spectrum, ranging from topical agents and superficially destructive modalities to surgical techniques and systemic therapy. Finally, we review the available literature and provide recommendations on prevention and the most appropriate follow-up for patients in whom BCC has been diagnosed. ( J Am Acad Dermatol

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Effect of Methyl Aminolevulinate Photodynamic Therapy With and Without Ablative Fractional Laser Treatment in Patients With Microinvasive Squamous Cell Carcinoma

2017

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IMPORTANCE Surgical excision is the standard treatment for cutaneous squamous cell carcinoma (SCC). However, microinvasive SCC (Clark level II) is limited to the papillary dermis, and it should be differentiated from invasive SCC. Ablative fractional laser-primed photodynamic therapy (AFL-PDT) may have enhanced efficacy. OBJECTIVE To compare 1 session of AFL-PDT with 2 sessions of conventional methyl aminolevulinate-PDT (MAL-PDT) for the treatment of microinvasive SCC. DESIGN, SETTING, AND PARTICIPANTSA 2-armed, randomized, single-blind, comparative trial of 45 patients with histologically proven microinvasive SCC. Twenty-one patients were randomized to treatment with a single AFL-PDT session, and 24 patients were randomized to 2 MAL-PDT sessions with a 1-week interval between sessions using a computer-generated program. Standard pretreatment such as curettage was not performed prior to PDT owing to a tendency to bleed. The efficacy, recurrence rate, cosmetic outcomes, and safety were assessed 1 week, 3, 12, and 24 months after the last treatment.INTERVENTIONS AFL was performed with an ablation depth of 550 μm to 600 μm, coagulation level of 1, treatment density of 22%, and a single pulse. Then, MAL cream was applied under occlusion for 3 hours and illuminated by using a red light-emitting diode light at 37 J/cm 2 . A second session of MAL-PDT was administered after 7 days. MAIN OUTCOMES AND MEASURESThe primary outcome measures were the lesion response at 3 and 12 months, and the recurrence rate 12 months after the last treatment.RESULTS Twenty-one patients (6 men, 15 women) with a mean (SD) age of 76 (6) years were randomized to treatment with a single AFL-PDT session, and 24 patients (11 men, 13 women) with a mean (SD) age of 75 (6) years were randomized to 2 MAL-PDT sessions. The overall complete response rates 3 months after treatment were 84.2% with AFL-PDT and 52.4% with MAL-PDT (P = .03). These differences in efficacy remained significant at the 24-month follow-up. The recurrence rate was significantly lower with AFL-PDT (12.5%) than with MAL-PDT (63.6%) at 24 months (P = .006). AFL-PDT and MAL-PDT did not differ significantly with respect to the cosmetic outcomes, adverse events, or pain intensity.CONCLUSIONS AND RELEVANCE AFL-PDT can be used as an alternative treatment option for patients with microinvasive SCC who are not suitable for surgical treatment.TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02666534

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Er:YAG ablative fractional laser‐primed photodynamic therapy with methyl aminolevulinate as an alternative treatment option for patients with thin nodular basal cell carcinoma: 12‐month follow‐up results of a randomized, prospective, comparative trial

Abstract: Er:YAG AFL-PDT can be used as an alternative treatment option for patients who have thin nBCC and are not suitable for surgical treatment.

Cited by 50 publications

References 22 publications

Laser‐assisted photodynamic therapy for superficial basal cell carcinoma and Bowen's disease: a randomized intrapatient comparison between a continuous and a fractional ablative CO₂ laser mode

Laser‐assisted photodynamic therapy for superficial basal cell carcinoma and Bowen's disease: a randomized intrapatient comparison between a continuous and a fractional ablative CO₂ laser mode

Guidelines of care for the management of basal cell carcinoma

Effect of Methyl Aminolevulinate Photodynamic Therapy With and Without Ablative Fractional Laser Treatment in Patients With Microinvasive Squamous Cell Carcinoma

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Er:YAG ablative fractional laser‐primed photodynamic therapy with methyl aminolevulinate as an alternative treatment option for patients with thin nodular basal cell carcinoma: 12‐month follow‐up results of a randomized, prospective, comparative trial

Abstract: Er:YAG AFL-PDT can be used as an alternative treatment option for patients who have thin nBCC and are not suitable for surgical treatment.

Cited by 50 publications

References 22 publications

Laser‐assisted photodynamic therapy for superficial basal cell carcinoma and Bowen's disease: a randomized intrapatient comparison between a continuous and a fractional ablative CO2 laser mode

Laser‐assisted photodynamic therapy for superficial basal cell carcinoma and Bowen's disease: a randomized intrapatient comparison between a continuous and a fractional ablative CO2 laser mode

Guidelines of care for the management of basal cell carcinoma

Effect of Methyl Aminolevulinate Photodynamic Therapy With and Without Ablative Fractional Laser Treatment in Patients With Microinvasive Squamous Cell Carcinoma

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Laser‐assisted photodynamic therapy for superficial basal cell carcinoma and Bowen's disease: a randomized intrapatient comparison between a continuous and a fractional ablative CO₂ laser mode

Laser‐assisted photodynamic therapy for superficial basal cell carcinoma and Bowen's disease: a randomized intrapatient comparison between a continuous and a fractional ablative CO₂ laser mode