Randomized comparison of photodynamic therapy with topical 5-fluorouracil in Bowen's disease

Salim, Asad; Leman, Joyce; McColl, John H.; Chapman, Robert S.; Morton, C.A.

doi:10.1046/j.1365-2133.2003.05033.x

Cited by 227 publications

(219 citation statements)

References 18 publications

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“…73 In this trial, MAL-PDT was found to be superior to 5FU and cryosurgery in both efficacy and cosmesis, 73 a finding corroborated by others. 71,72 Unfortunately, PDT has shown very poor efficacy in managing invasive SCC. 74 Given the poor healing of SCC in situ lesions of the lower leg in response to more established therapies, PDT may be a logical option in such cases.…”

Section: Photodynamic Therapymentioning

confidence: 99%

“…69 A number of studies have highlighted the effectiveness of 1 to 2 ALA-PDT treatment sessions in treating SCC in situ, with complete response at 12 months ranging from 80% to 100%. [70][71][72] ALA-PDT has shown particular efficacy in treating SCC in situ located on the lower leg, 71 a region of poor healing with other therapies. In a large randomized controlled trial that included 225 SCC in situ patients, MAL-PDT produced an 80% complete response rate by 12 months of follow-up, along with a good or excellent cosmetic outcome in 97% of cases.…”

Section: Photodynamic Therapymentioning

confidence: 99%

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Non-melanoma Skin Cancer in Canada Chapter 5: Management of Squamous Cell Carcinoma

et al. 2015

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Background Squamous cell carcinoma (SCC) is the second-most common form of non-melanoma skin cancer (NMSC). Objective To provide guidance to Canadian health care practitioners regarding management of SCCs. Methods Literature searches and development of graded recommendations were carried out as discussed in the accompanying introduction (chapter 1 of the NMSC guidelines). Results SCCs are sometimes confined to the epidermis, but they can also invade nearby tissues and, in some cases, metastasize to neighbouring lymph nodes or other organs. This chapter discusses the natural history, staging, prognosis, and management of SCC—a tumour type that is less common but typically more aggressive than BCC. For this reason, margin control is strongly preferred in treating SCCs. Conclusions Although approaches such as cryosurgery and radiation therapy may be considered for some patients, surgical excision—sometimes coupled with radiation—remains the cornerstone of SCC management. Patients with high-risk SCC may also be considered for referral to an appropriate multidisciplinary clinic.

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Section: Photodynamic Therapymentioning

confidence: 99%

Section: Photodynamic Therapymentioning

confidence: 99%

Non-melanoma Skin Cancer in Canada Chapter 5: Management of Squamous Cell Carcinoma

et al. 2015

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“…Os estudos mostram excelente resultados cosméticos entre 91% e 98% dos pacientes tratados. 22,28,39,40 Em relação à doença de Bowen (DB), os estudos conduzidos com ALA (em geral ALA 20% em formulação com creme e com fontes de luz variáveis) mostram índices de cura de 88% a 100%. 28,[39][40][41] No maior estudo multicêntrico conduzido por Morton e cols, o índice de cura inicial foi de 93%.…”

Section: Aplicações Clínicas Oncológicas Em Dermatologiaunclassified

Terapia fotodinâmica em dermatologia: princípios básicos e aplicações

Torezan

Niwa

Neto³

2009

An. Bras. Dermatol.

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Resumo:A terapia fotodinâmica envolve a administração de uma droga fotossensibilizante e sua ativação subsequente pela luz de comprimento de onda correspondente ao espectro de absorção do fotossensibilizador. Atualmente, a terapia fotodinâmica tópica é aprovada para o tratamento de condições oncológicas cutâneas como queratoses actínicas, doença de Bowen e carcinoma basocelular superficial em diversos países do mundo. Estudos multicêntricos controlados e randomizados demonstram a alta eficácia e resultado cosmético final superior dessa modalidade terapêutica em relação aos tratamentos convencionais. Para condições cutâneas não oncológicas, como acne vulgar, verrugas virais e esclerodermia localizada, há também relatos e série de casos confirmando o potencial terapêutico da terapia fotodinâmica. O desenvolvimento de fotossensibilizantes tópicos, ácido 5-aminolevulínico (ALA) ou seu metiléster (MAL), frente aos derivados da hematoporfirina de aplicação sistêmica, permitiu um grande avanço na popularidade da TFD na dermatologia, uma vez que tanto ALA quanto MAL tópicos não induzem mais fotossensibilidade generalizada prolongada. A produção de intermediários reativos de oxigênio, como oxigênio singlet, depende da concentração, da localização do fotossensibilizante no tecido alvo, assim como da dose de luz utilizada. Tanto as lâmpadas de amplo espectro quanto os LEDs (do inglês light emitting diodes) constituem fontes de luz adequadas para que os efeitos citotóxicos da terapia fotodinâmica resultem na destruição do tumor ou seus efeitos imunomodulatórios atuem melhorando as condições inflamatórias cutâneas. Palavras-chave: Carcinoma basocelular; Carcinoma in situ; Fotoquimioterapia Abstract: Photodynamic therapy involves the administration of a photosensitizing drug and its subsequent activation by light at wavelengths matching the absorption spectrum of the photosensitizer. Currently, topical photodynamic therapy has received approval for the treatment of cutaneous oncologic conditions such as actinic keratoses, Bowen's disease and superficial basal cell carcinoma in many countries in the world. Multicenter randomized controlled studies have demonstrated high efficacy and superior cosmetic outcome over standard therapies. For many non-oncologic dermatological diseases such as acne vulgaris, viral warts and localized scleroderma, case reports and small series have confirmed the potential of photodynamic therapy. After the development of topical photosensitizers 5-aminolevulinic acid (ALA) or its methyl ester (MAL), photodynamic therapy has gained worldwide popularity in dermatology, as these drugs do not induce prolonged phototoxicity as the systemic photosensitizing hematoporphyrin derivatives do. The production of reactive oxygen intermediates such as singlet oxygen depends on the concentration and localization of the photosensitizer in the diseased tissue as well as the applied light dose. Either incoherent lamps or LED arrays are suitable for the cytotoxic effects resulting in tumor destruction or immunomodulator...

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“…ALA combined with red light has significantly better results than the ones obtained with 5-fluorouracil or cryotherapy at 12 months follow-up with good or excellent cosmetic outcome (Morton et al, 2002). Comparing the effects of 20% ALA-PDT and fluorouracil therapy, a bicentric randomized trial showed a complete response in 88% of the lesions treated with ALA-PDT and only 67% after treatment with fluorouracil (Salim et al, 2003). However, literature data regarding the effect of PDT in Bowen's disease are controversial, some researchers reporting positive results in 90-100%, while others only in 50% of the cases (Fijan et al, 1995).…”

Section: Squamous Cell Carcinomamentioning

confidence: 99%

Photodynamic Therapy in Skin Cancer

Clichici¹,

Filip²

2011

Skin Cancers - Risk Factors, Prevention and Therapy

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Randomized comparison of photodynamic therapy with topical 5-fluorouracil in Bowen's disease

Abstract: Topical ALA-PDT is more effective than topical 5-FU in the treatment of BD, with fewer adverse events. ALA-PDT should be considered one of the first-line therapeutic options for BD.

Cited by 227 publications

References 18 publications

Non-melanoma Skin Cancer in Canada Chapter 5: Management of Squamous Cell Carcinoma

Non-melanoma Skin Cancer in Canada Chapter 5: Management of Squamous Cell Carcinoma

Terapia fotodinâmica em dermatologia: princípios básicos e aplicações

Photodynamic Therapy in Skin Cancer

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