Topical methyl aminolevulinate photodynamic therapy for management of basal cell carcinomas in patients with basal cell nevus syndrome improves patient’s satisfaction and reduces the need for surgical procedures

Pauwels, C.; Mazereeuw‐Hautier, J.; Basset-Séguin, Nicole; Livideanu, C. Bulai; Viraben, R.; Paul, C.; Meyer, Nicolas

doi:10.1111/j.1468-3083.2010.03854.x

Cited by 24 publications

(25 citation statements)

References 11 publications

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“…PDT is a potentially useful option for patients with naevoid BCC syndrome (NBCCS), with series and cases reported and a large cohort of 33 patients treated by topical or systemic PDT, depending on whether lesions were less than/greater than 2 mm in thickness when assessed by ultrasound 2,73 . MAL‐PDT for NBCCS can improve patient satisfaction and reduces the need for surgical procedures 74 …”

Section: Superficial Basal Cell Carcinoma (Strength Of Recommendationmentioning

confidence: 99%

European guidelines for topical photodynamic therapy part 1: treatment delivery and current indications – actinic keratoses, Bowen’s disease, basal cell carcinoma

Morton¹,

Szeimies

Sidoroff

et al. 2012

Acad Dermatol Venereol

316

327

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Topical photodynamic therapy (PDT) is a widely used non-invasive treatment for certain non-melanoma skin cancers, permitting treatment of large and multiple lesions with excellent cosmesis. High efficacy is demonstrated for PDT using standardized protocols in non-hyperkeratotic actinic keratoses, Bowen's disease, superficial basal cell carcinomas (BCC) and in certain thin nodular BCC, with superiority of cosmetic outcome over conventional therapies.Recurrence rates following PDT are typically equivalent to existing therapies, although higher than surgery for nodular BCC. PDT is not recommended for invasive squamous cell carcinoma. Treatment is generally well tolerated, but tingling discomfort or pain is common during PDT. New studies identify patients most likely to experience discomfort and permit earlier adoption of pain-minimization strategies. Reduced discomfort has been observed with novel protocols including shorter photosensitizer application times and in daylight PDT for actinic keratoses.

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Section: Superficial Basal Cell Carcinoma (Strength Of Recommendationmentioning

confidence: 99%

European guidelines for topical photodynamic therapy part 1: treatment delivery and current indications – actinic keratoses, Bowen’s disease, basal cell carcinoma

Morton¹,

Szeimies

Sidoroff

et al. 2012

Acad Dermatol Venereol

316

327

View full text Add to dashboard Cite

show abstract

“…PDT has been used to treat patients with Gorlin syndrome/NBCCS, with a large cohort of 33 patients treated by topical or systemic PDT, depending on whether lesions were less or greater than 2 mm in thickness as assessed by ultrasonography [129]. A recent short report found that MAL-PDT for NBCCS improves patient satisfaction and reduces the need for surgical procedures [130]. Topical PDT has been used to treat BCC in immunosuppressed patients with ALA-PDT clearing 30/32 facial tumours (including 21 BCC) in 5 OTR after one to three treatments [131].…”

Section: Photodynamic Therapymentioning

confidence: 99%

Update of the European guidelines for basal cell carcinoma management

Trakatelli¹,

Morton²,

Nagore³

et al. 2014

European Journal of Dermatology

204

197

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Background European guidelines for the management of basal cell carcinoma (BCC) prepared by the former BCC subcommittee of the Guidelines Committee of the European Dermatology Forum (EDF) were published in 2006. Objectives To present updated guidelines that include consensual expert definitions on various BCC types, prognosis and risk factors for BCC as well as review recommendations for diagnosis and treatment reflecting current published evidence. Methods These guidelines (S1 type) were prepared by the new BCC subgroup of the European Dermatology Forum (EDF)'s Guidelines Committee through extensive literature review (up to 2012) and expert experience; they were extensively discussed within the EDF subcommittee and approved by peer reviewers of the EDF. Results BCC is a common tumour with an incidence rising worldwide. Three major clinical types of BCC are recognized: nodular, superficial and morpheaform. Four histological subtypes are defined: superficial, nodular, infiltrative and morpheaform. On the basis of the risk of relapse, three prognosis groups have been identified: high, intermediate and low risk. According to these classifications and evidence-based evaluation of the therapeutic strategies available, a decision tree is proposed for the management of BCCs. Conclusions. The guidelines offer a useful tool that will help dermatologists to select the most appropriate treatment for individual patients.

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“…This could be especially beneficial for patients with Nevoid Basal Cell Carcinoma syndrome, where numerous and extensive lesions occur early and throughout life 25; 26 and who may not be candidates for Vismodegib treatment. Clinical outcomes of MAL-PDT also compare favorably with imiquimod therapy 27 .…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of Pain Control by a 2-Step Irradiance Schedule During Topical Photodynamic Therapy of Nonmelanoma Skin Cancer

Zeitouni

Sunar²,

Rohrbach³

et al. 2014

Dermatologic Surgery

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Background Topical photodynamic therapy (PDT) for selected non-melanoma skin cancer, employing 5-aminolevulinic acid (ALA) or methyl aminolevulinate (MAL) has yielded high long-term complete response rates with very good cosmesis. Pain during light activation of the photosensitizer can be a serious adverse event. A two-step irradiance protocol has previously been shown to minimize ALA-PDT pain. Objectives To determine the irradiance-dependent pain threshold for MAL-PDT, to adapt the two-step protocol to an LED light source, and assess clinical response. Methods In this prospective study, 25 superficial basal cell carcinoma (sBCC) received an initial irradiance by laser at 40 or 50 mW/cm2, or LED at 35 mW/cm2 followed by an irradiance at 70 mW/cm2 for a total of 75 J/cm2. Pain levels were recorded for both irradiance steps. Efficacy was assessed at 6, 12 or 24 months. Results Pain was mild in the 40/70 mW/cm2 laser cohort. Three instances of irradiance-limiting pain occurred at 50/70 mW/cm2. Pain was minimal in the 35/70 mW/cm2 LED cohort. Clinical response rates were 80% in the 50/70 mW/cm2 laser cohort and 90% in the 35/70 mW/cm2 LED cohort. Conclusions Topical PDT can be effectively delivered to sBCC with minimal treatment related pain by a two-step irradiance protocol.

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Topical methyl aminolevulinate photodynamic therapy for management of basal cell carcinomas in patients with basal cell nevus syndrome improves patient’s satisfaction and reduces the need for surgical procedures

Abstract: Methylaminolevulinate-photodynamic therapy seems an interesting option for the treatment of basal cell carcinomas in patients with basal cell nevus syndrome.

Cited by 24 publications

References 11 publications

European guidelines for topical photodynamic therapy part 1: treatment delivery and current indications – actinic keratoses, Bowen’s disease, basal cell carcinoma

European guidelines for topical photodynamic therapy part 1: treatment delivery and current indications – actinic keratoses, Bowen’s disease, basal cell carcinoma

Update of the European guidelines for basal cell carcinoma management

A Prospective Study of Pain Control by a 2-Step Irradiance Schedule During Topical Photodynamic Therapy of Nonmelanoma Skin Cancer

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