- MeSH
- Carcinoma, Basal Cell * drug therapy surgery MeSH
- Sentinel Lymph Node Biopsy MeSH
- Photochemotherapy methods MeSH
- Humans MeSH
- Lymph Node Excision MeSH
- Melanoma * diagnosis surgery MeSH
- Neoplasms, Squamous Cell * surgery MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: The major limitation of photodynamic therapy with 5-aminolevulinic acid (ALA-PDT) is proper photosensitizer penetration. The nodular form of BCC (nBCC) is perceived as a contraindication to ALA-PDT because the tumor layer is thicker than 2 mm. We have improved on the results of previous studies that used an ablative laser to limit tumor thickness. A fractional laser produces skin microtubules that can improve the penetration of ALA into tumors. OBJECTIVE: To evaluate the use of a fractional laser as pretreatment before ALA-PDT for nBCC treatment in an 18-month single-blind clinical trial. METHODS: Fifty-six verified nBCCs were ablated using a diode laser under ultrasound control. Half of the tumors were treated 3 weeks later using a fractional carbon dioxide laser, and the other half were treated using curettage (control). We then immediately treated with ALA-PDT. Fluorescence and photography were evaluated and compared each month, and a final histopathologic examination was performed. RESULTS: Fifty-two of 56 nBCCs in the fractional laser treatment group responded to ALA-PDT, compared with only 45 of 56 in the control group. Fluorescence was higher in 53 cases in the treatment group; 3 cases demonstrated the same fluorescence level in both groups. Healing took longer in the treatment group, and there were more side effects. CONCLUSION: Fractional laser pretreatment increases the fluorescence and clinical effectiveness of ALA-PDT for the treatment of nBCC.
- MeSH
- Carcinoma, Basal Cell pathology surgery MeSH
- Photochemotherapy * MeSH
- Photosensitizing Agents administration & dosage MeSH
- Neoplasm Invasiveness MeSH
- Combined Modality Therapy MeSH
- Aminolevulinic Acid administration & dosage analogs & derivatives MeSH
- Lasers, Gas therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Recurrence, Local pathology MeSH
- Microtubules MeSH
- Skin Neoplasms pathology surgery MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
