Methyl aminolevulinate photodynamic therapy after partial debulking in the treatment of superficial and nodular basal cell carcinoma: 3-years follow-up

Gómez, Clara; Cobos, Pedro L.; Alberdi, Enrique

doi:10.1016/j.pdpdt.2021.102176

Cited by 6 publications

(5 citation statements)

References 31 publications

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“…121 Where PDT has been used to treat nonmelanoma skin cancers, including BCC, SCC, Bowen’s disease, and AK, the majority of the published work has studied efficacy in people with FST I–II. 112 , 122 – 125 This is probably because skin cancers are more prevalent in pale-skinned populations with the people with the darkest skin being diagnosed, with approximately one twentieth of the cases of skin cancer of those with the palest skin. 126 Nevertheless, there are incorrect perceptions that skin cancers are unique to the lighter-skinned population and morbidity in darker-skinned people is greater due to later diagnosis, with 70% 5-year survival rate in dark-skinned people compared with 92% in lighter-skinned people.…”

Section: Importance Of Accurately Determining the Optical Properties ...mentioning

confidence: 99%

Effect of skin color on optical properties and the implications for medical optical technologies: a review

Setchfield,

Gorman,

Simpson

et al. 2024

J. Biomed. Opt.

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Skin color affects light penetration leading to differences in its absorption and scattering properties. COVID-19 highlighted the importance of understanding of the interaction of light with different skin types, e.g., pulse oximetry (PO) unreliably determined oxygen saturation levels in people from Black and ethnic minority backgrounds. Furthermore, with increased use of other medical wearables using light to provide disease information and photodynamic therapies to treat skin cancers, a thorough understanding of the effect skin color has on light is important for reducing healthcare disparities.Aim: The aim of this work is to perform a thorough review on the effect of skin color on optical properties and the implication of variation on optical medical technologies.Approach: Published in vivo optical coefficients associated with different skin colors were collated and their effects on optical penetration depth and transport mean free path (TMFP) assessed.Results: Variation among reported values is significant. We show that absorption coefficients for dark skin are ∼6% to 74% greater than for light skin in the 400 to 1000 nm spectrum. Beyond 600 nm, the TMFP for light skin is greater than for dark skin. Maximum transmission for all skin types was beyond 940 nm in this spectrum. There are significant losses of light with increasing skin depth; in this spectrum, depending upon Fitzpatrick skin type (FST), on average 14% to 18% of light is lost by a depth of 0.1 mm compared with 90% to 97% of the remaining light being lost by a depth of 1.93 mm.Conclusions: Current published data suggest that at wavelengths beyond 940 nm light transmission is greatest for all FSTs. Data beyond 1000 nm are minimal and further study is required. It is possible that the amount of light transmitted through skin for all skin colors will converge with increasing wavelength enabling optical medical technologies to become independent of skin color.

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Section: Importance Of Accurately Determining the Optical Properties ...mentioning

confidence: 99%

Effect of skin color on optical properties and the implications for medical optical technologies: a review

Setchfield,

Gorman,

Simpson

et al. 2024

J. Biomed. Opt.

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“…PDT has shown therapeutic efficacy as an off-label treatment for BCC in clinical practice [ 4 ]. Because PDT cannot penetrate lesions beyond 2 mm deep, the use of surgical curettage to reduce tumor depth to less than 2 mm followed by subsequent PDT may be beneficial in the treatment of BCC [ 23 , 29 ]. Data suggest that debulking thicker tumors prior to PDT treatment increases complete response rate after 3 years of follow-up relative to older studies where pretreatment debulking may not have been performed [ 29 , 30 ].…”

Section: Advances In Clinical Applicationmentioning

confidence: 99%

Section: Advances In Clinical Applicationmentioning

confidence: 99%

“…Studies utilizing 5-ALA or MAL have demonstrated promising results for the treatment of BCC (Table 2 ) [ 29 , 31 – 33 ]. In a 3-year, prospective, open-label trial of 174 adult patients with dermoscopically/histologically confirmed superficial BCC and nodular BCC, combining curettage of visible tumor (sparing dermis and adjacent normal skin) with 16% MAL cream and photoactivation with red light-emitting diode (LED) light for 23 min resulted in overall 3-year clearance rates of 96.1% after a mean of 2.6 sessions for superficial BCC and 95.2% after a mean of 2.7 sessions for nodular BCC [ 29 ]. An open-label trial assessing 12% 5-ALA-PDT gel with a 3-h incubation period and photoactivation with red light for the treatment of superficial BCCs on the head and neck, trunk, and extremities achieved a complete response rate of 95.8% at 3 months after the second treatment session and a 3-year recurrence-free survival rate of 88.3% [ 31 ].…”

Section: Advances In Clinical Applicationmentioning

confidence: 99%

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Advances in Photodynamic Therapy for the Treatment of Actinic Keratosis and Nonmelanoma Skin Cancer: A Narrative Review

Farberg

Marson

Soleymani

2023

Dermatol Ther (Heidelb)

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Photodynamic therapy (PDT) with photosensitization using 5-aminolevulinic acid (ALA) [including a nanoemulsion (BF-200 ALA)] is approved in the USA for the treatment of actinic keratoses (AKs); another derivative, methyl aminolevulinate, is not approved in the USA but is used in Europe. For AK treatment, the photosensitizer may be applied to individual AK lesions or, depending on treatment regimen, to broader areas of sun-damaged skin to manage field cancerization, although not all products are approved for field treatment. ALA-PDT and photosensitizers have also been used off-label for the treatment of nonmelanoma skin cancers, primarily basal cell carcinomas (BCCs) and cutaneous squamous cell carcinomas (cSCC). Advantages of PDT include potentially improved cosmesis and patient satisfaction; disadvantages include pain and duration of treatment. Alternative illumination approaches, including intense pulsed light as well as pulsed-dye lasers, have also been used successfully. Pretreating the affected tissue or warming during incubation can help to increase photosensitizer absorption and improve therapeutic efficacy. Combinations of multiple treatments are also under exploration. Reducing incubation time between photosensitizer application and illumination may significantly reduce pain scores without affecting treatment efficacy. Substituting daylight PDT for a conventional illumination source can also reduce pain without compromising efficacy. The objective of this narrative review is to describe current and ongoing research in the use of topical photosensitizers and modified light delivery regimens to achieve improved therapeutic outcomes with less toxicity in patients with AK, cSCC, BCC, and field cancerization.

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“…Several reports showed that different non‐surgical treatments have resulted in impressive prognosis. Gómez et al 5 use methyl aminolevulinate‐mediated photodynamic therapy in 74 patients suffering from sBCC and found that after an average of 2.6 sessions, the overall clearance rate at 3‐year follow‐up was 96.1%. Lebas et al 6 used oxygen flow‐assisted LP3‐MTX3% for treating sBCC.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Sonographic Characteristics Between Superficial Basal Cell Carcinoma and Non‐Superficial Basal Cell Carcinomas

Liang

Luo

Zhang

et al. 2023

J of Ultrasound Medicine

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Objectives To compare the sonographic characteristics of superficial basal cell carcinoma (sBCC) and non‐superficial basal cell carcinomas (nsBCC). Methods The ultrasound characteristics of 73 basal cell carcinoma (BCC) confirmed by surgical pathology were retrospectively analyzed, and the cases were divided into 11 cases of sBCC and 62 cases of nsBCC according to pathological subtypes. Ultrasound characteristics between groups were compared. Results Among all the ultrasound characteristics, lesion thickness (P = .000), shape (χ2 = 39.293, P = .000), basal changes (χ2 = 8.473, P = .037), infiltration level (χ2 = 46.140, P = .000), and distribution of intralesional hyperechogenic spots (χ2 = 15.699, P = .000) of the lesions had statistically significant correlation with pathological diagnosis of sBCC. While no significant differences were shown in surface morphology, keratinization, maximum diameter, intralesional echogenicity, posterior echogenic changes, and intralesional color Doppler flow of the lesions. Conclusions Small lesion thickness, oblate shape, superficial dermal local infiltration, and <3 internal hyperechogenic spots distribution of BCC determined by high frequency ultrasound may positively correlate with pathological diagnosis of sBCC. This is beneficial for treatment planning.

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Methyl aminolevulinate photodynamic therapy after partial debulking in the treatment of superficial and nodular basal cell carcinoma: 3-years follow-up

Cited by 6 publications

References 31 publications

Effect of skin color on optical properties and the implications for medical optical technologies: a review

Effect of skin color on optical properties and the implications for medical optical technologies: a review

Advances in Photodynamic Therapy for the Treatment of Actinic Keratosis and Nonmelanoma Skin Cancer: A Narrative Review

Comparison of Sonographic Characteristics Between Superficial Basal Cell Carcinoma and Non‐Superficial Basal Cell Carcinomas

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