Topical calcipotriol before ablative fractional laser-assisted photodynamic therapy enhances treatment outcomes for actinic keratosis in Fitzpatrick grades III-V skin: A prospective randomized clinical trial

Seo, Jeong-Wan; Song, Ki‐Hoon

doi:10.1016/j.jaad.2017.11.027

Cited by 14 publications

(9 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical and histological improvement was superior on the calcipotriol‐assisted side (overall AK clearance rates were 92.1% and 82.0%, respectively) with greatest improvement for grade II AKs (90% vs.63%) although pain and also local side‐effects were greater with the combined protocol . A prospective randomized clinical trial using ablative fractional laser‐assisted MAL‐PDT after twice daily topical 0.005% calcipotriol pretreatment for 2 weeks showed a higher rate of complete response of facial AK with the combined treatment (89% vs.80%) and lower recurrence rate at 12 months (5% vs.10%) …”

Section: Current Indicationsmentioning

confidence: 99%

“…71 A prospective randomized clinical trial using ablative fractional laser-assisted MAL-PDT after twice daily topical 0.005% calcipotriol pretreatment for 2 weeks showed a higher rate of complete response of facial AK with the combined treatment (89% vs.80%) and lower recurrence rate at 12 months (5% vs.10%). 72 A systematic review and metaanalysis of laser-assisted PDT for AK identified seven randomized controlled trials with four included in the analysis. 73 Laser-assisted PDT showed significantly higher clearance rates than PDT monotherapy with no difference in pain intensity between laser-assisted PDT and PDT or laser monotherapy.…”

Section: Current Indicationsmentioning

confidence: 99%

See 1 more Smart Citation

European Dermatology Forum guidelines on topical photodynamic therapy 2019 Part 1: treatment delivery and established indications – actinic keratoses, Bowen's disease and basal cell carcinomas

Morton¹,

Szeimies

Basset-Séguin

et al. 2019

Acad Dermatol Venereol

148

146

View full text Add to dashboard Cite

Topical photodynamic therapy (PDT) is a widely approved therapy for actinic keratoses, Bowen's disease (squamous cell carcinoma in situ), superficial and certain thin basal cell carcinomas. Recurrence rates when standard treatment protocols are used are typically equivalent to existing therapies, although inferior to surgery for nodular basal cell carcinoma. PDT can be used both as lesional and field therapies and has the potential to delay/reduce the development of new lesions. A protocol using daylight to treat actinic keratoses is widely practised, with conventional PDT using a red light after typically a 3‐h period of occlusion employed for other superficial skin cancer indications as well as for actinic keratoses when daylight therapy is not feasible. PDT is a well‐tolerated therapy although discomfort associated with conventional protocol may require pain‐reduction measures. PDT using daylight is associated with no or minimal pain and preferred by patient. There is an emerging literature on enhancing conventional PDT protocols or combined PDT with another treatment to increase response rates. This guideline, published over two parts, considers all current approved and emerging indications for the use of topical PDT in dermatology, prepared by the PDT subgroup of the European Dermatology Forum guidelines committee. It presents consensual expert recommendations reflecting current published evidence.

show abstract

Section: Current Indicationsmentioning

confidence: 99%

Section: Current Indicationsmentioning

confidence: 99%

European Dermatology Forum guidelines on topical photodynamic therapy 2019 Part 1: treatment delivery and established indications – actinic keratoses, Bowen's disease and basal cell carcinomas

Morton¹,

Szeimies

Basset-Séguin

et al. 2019

Acad Dermatol Venereol

148

146

View full text Add to dashboard Cite

show abstract

“…Calcipotriol, a synthetic vitamin D derivative, may be used before PDT [70]. Patients undergoing PDT who were pretreated with calcipotriol were found to have fewer side effects and a higher clearance rate of AKs compared to those who received PDT only [71-73]. Calcipotriol pretreatment is thought to boost the amount of PpIX in the skin, thereby enhancing efficacy of field treatment [72].…”

Section: Management/treatmentmentioning

confidence: 99%

Updates on Treatment Approaches for Cutaneous Field Cancerization

et al. 2019

View full text Add to dashboard Cite

Purpose of Review Field cancerization describes the phenomenon that multiple heterogenous mutations may arise in an area exposed to chronic carcinogenic stimuli. Advances in the understanding of cutaneous field cancerization have led to novel therapeutic approaches to the management of actinic keratoses (AKs). Herein, we review the literature on the pathophysiology and emerging research of field cancerization in dermatology. Recent Findings The classification systems for grading AK lesions are being refined with investigations focusing on their clinical utility. There is a growing shift towards field-directed treatment for AKs as the importance of field cancerization becomes clearer. Current field-directed therapies are being optimized and novel therapeutic modalities are being studied. Summary Field cancerization underlies the transformation of photodamaged skin into AKs and potentially cutaneous SCC (cSCC). Clinically meaningful classification systems for AKs are needed to better inform decisions regarding treatment. As we learn more about the role of field characterization in photodamage, AKs and cSCCs, therapeutic strategies are becoming more field-directed rather than lesion-directed.

show abstract

“…Cells that are poorly differentiated and rapidly proliferating, as is common in many tumors, may produce insufficient amounts of PpIX . One area of investigation to address this issue involves the use of cellular differentiators such as vitamin D or its analogues, methotrexate, retinoic acid, 5‐fluorouracil acid, iron chelators and the androgens 5α‐dihydrotestosterone (DHT) and R1881 .…”

Section: Targeting the Tumor Microenvironment With Photochemistrymentioning

confidence: 99%

“…As discussed in a previous section, the EPR effect occurs due to the tendency of tumors to develop abnormal vascular networks with poor lymphatic drainage. An imbalance of proangiogenic and antiangiogenic signals at the tumor site leads to the development of abnormal vascular networks, which often lack the organization of typical vascular networks, and are tortuous and (191,192,203,(211)(212)(213)…”

Section: Functional Targetingmentioning

confidence: 99%

Photodynamic Therapy and the Biophysics of the Tumor Microenvironment

Sorrin

Ruhi

Ferlic

et al. 2020

Photochem & Photobiology

View full text Add to dashboard Cite

Targeting the tumor microenvironment (TME) provides opportunities to modulate tumor physiology, enhance the delivery of therapeutic agents, impact immune response and overcome resistance. Photodynamic therapy (PDT) is a photochemistry‐based, nonthermal modality that produces reactive molecular species at the site of light activation and is in the clinic for nononcologic and oncologic applications. The unique mechanisms and exquisite spatiotemporal control inherent to PDT enable selective modulation or destruction of the TME and cancer cells. Mechanical stress plays an important role in tumor growth and survival, with increasing implications for therapy design and drug delivery, but remains understudied in the context of PDT and PDT‐based combinations. This review describes pharmacoengineering and bioengineering approaches in PDT to target cellular and noncellular components of the TME, as well as molecular targets on tumor and tumor‐associated cells. Particular emphasis is placed on the role of mechanical stress in the context of targeted PDT regimens, and combinations, for primary and metastatic tumors.

show abstract

Topical calcipotriol before ablative fractional laser-assisted photodynamic therapy enhances treatment outcomes for actinic keratosis in Fitzpatrick grades III-V skin: A prospective randomized clinical trial

Cited by 14 publications

References 5 publications

European Dermatology Forum guidelines on topical photodynamic therapy 2019 Part 1: treatment delivery and established indications – actinic keratoses, Bowen's disease and basal cell carcinomas

European Dermatology Forum guidelines on topical photodynamic therapy 2019 Part 1: treatment delivery and established indications – actinic keratoses, Bowen's disease and basal cell carcinomas

Updates on Treatment Approaches for Cutaneous Field Cancerization

Photodynamic Therapy and the Biophysics of the Tumor Microenvironment

Contact Info

Product

Resources

About