Document Detail


Topical 5-aminolevulinic acid mediated photodynamic therapy of superficial basal cell carcinoma using two light fractions with a two-hour interval: long-term follow-up.
MedLine Citation:
PMID:  16955185     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Photodynamic therapy (PDT) of superficial basal cell carcinoma using topical 5-aminolaevulinic acid (ALA) and 75-100 J/cm2 light dose yields unsatisfactory long-term results. In several animal models, illumination with two light fractions approximately 2 h apart was considerably more effective than single illumination, suggesting the need for a pilot clinical study. Fifteen patients with a total of 86 primary superficial basal cell carcinomas, received topical ALA and were illuminated 4 and 6 h later, both with 45 J/cm2 laser light (633+/-1 nm). Fluorescence spectra were measured before and immediately after each illumination. At a mean follow-up of 59 months (range 44-82), 67 lesions could be evaluated, 56 of which showed a complete response (84%). Cosmesis was good/excellent in 88% of the complete response group and fair in 12%. There was no correlation between protoporphyrin fluorescence and response, but a significant correlation between the percentage of fluorescence left after photobleaching by the first illumination and the amount of protoporphyrin re-synthesized 2 h later. In conclusion, the long-term complete remission rate of fractionated ALA-mediated PDT of superficial basal cell carcinoma as reported here is significantly better than after PDT with single illumination previously reported by others, but equal to studies using single illumination with a much higher light fluence. Further improvement may be possible by reducing the fluence of the first fraction, with constant total fluence.
Authors:
Willem M Star; Albert J van't Veen; Dominic J Robinson; Kai Munte; Ellen R M de Haas; Henricus J C M Sterenborg
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta dermato-venereologica     Volume:  86     ISSN:  0001-5555     ISO Abbreviation:  Acta Derm. Venereol.     Publication Date:  2006  
Date Detail:
Created Date:  2006-09-06     Completed Date:  2006-11-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370310     Medline TA:  Acta Derm Venereol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  412-7     Citation Subset:  IM    
Affiliation:
Photodynamic Therapy and Optical Spectroscopy Program, Department of Radiation Oncology, Daniel den Hoed Oncology Centre, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Aminolevulinic Acid / administration & dosage,  therapeutic use*
Carcinoma, Basal Cell / drug therapy*
Female
Fluorescence
Humans
Male
Middle Aged
Photochemotherapy / methods*
Pilot Projects
Protoporphyrins / analysis
Skin Neoplasms / drug therapy*
Chemical
Reg. No./Substance:
0/Protoporphyrins; 106-60-5/Aminolevulinic Acid; 553-12-8/protoporphyrin IX

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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