1
|
Petzold A, Wessely A, Steeb T, Berking C, Heppt MV. Efficacy of interventions for cutaneous squamous cell carcinoma in situ (Bowen's disease): A systematic review and meta-analysis of proportions. J Eur Acad Dermatol Venereol 2024. [PMID: 39148440 DOI: 10.1111/jdv.20267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/11/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma in situ (Bowen's disease) is a precancerous condition confined to the epidermis of the skin. Despite the critical need for effective interventions to halt its progression, there remains a notable shortage of comprehensive data comparing the efficacy of various therapeutic approaches. OBJECTIVES This systematic review and meta-analysis endeavour to compare the different efficacies of interventions by investigating and synthesizing data from numerous trials. METHODS A pre-defined protocol was registered in PROSPERO (CRD42021242224, registration date: 16 April 2021). Systematic searches in Medline, Embase and Central, along with manual trial register searches, identified studies reporting lesion clearance rates (LCR), participant clearance rates (PCR) or recurrence rates (date of last search: 12 June 2024). Quality assessment followed guidelines from the National Heart, Lung, and Blood Institute (NHLBI). After the study arms were categorized into treatment groups and groups of study quality, the proportions were pooled using the generalized linear mixed model (GLMM) as meta-analytical method. RESULTS A comprehensive inclusion of 71 studies facilitated an evaluation of 3783 lesions for LCR, 1225 patients for PCR, 4073 lesions for lesion recurrence rates (LRR) and 740 patients for participant recurrence rates (PRR). Surgery demonstrated the highest LCR and PCR (0.97, 95% confidence interval (CI): 0.90-0.99) and the lowest LRR (0.04, 95% CI: 0.02-0.07). CONCLUSIONS This study provides a thorough overview of reported efficacy outcomes for practice-relevant interventions for Bowen's disease. Surgery outperformed other treatments for Bowen's disease. For the other intervention groups, it was not possible to show clear differences in effectiveness: LCR, PCR, LRR and PRR showed various treatment rankings, and the comparability was restricted by different numbers of studies between treatment groups and outcome measures, methodical and clinical heterogeneity. Further high-quality studies are needed to investigate practice-relevant interventions for Bowen's disease.
Collapse
Affiliation(s)
- Anne Petzold
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen - European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Uniklinikum Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Anja Wessely
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen - European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Uniklinikum Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Theresa Steeb
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen - European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Uniklinikum Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Carola Berking
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen - European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Uniklinikum Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Markus V Heppt
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen - European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Uniklinikum Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| |
Collapse
|
2
|
Evaluation of photodynamic effect of Indocyanine green (ICG) on the colon and glioblastoma cancer cell lines pretreated by cold atmospheric plasma. Photodiagnosis Photodyn Ther 2021; 35:102408. [PMID: 34171459 DOI: 10.1016/j.pdpdt.2021.102408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/03/2021] [Accepted: 06/14/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cold Atmospheric Plasma (CAP) has been proposed as a new approach based on its anticancer potential. However, its biological effects in combination with other physical modalities may also enhance efficiency and expand the applicability of the CAP method Photodynamic Therapy (PDT) may be improved by the use of indocyanine green (ICG) photosensitizer with absorption wavelength in the near infrared region to allow for deeper treatment depth.. In this study, the effectiveness of cold atmospheric helium plasma (He-CAP) as a pretreatment on the efficiency of ICG mediated PDT was investigated. METHODS AND MATERIAL First, toxicity of different concentrations of ICG on HT-29 and U-87MG cell lines was examined for 24 h. IC10 and IC30 of ICG were determined and then cells were treated with this ICG concentrations with different plasma radiation doses and light exposures for 48 h. Finally, MTT assay was performed for all treatment groups. The experiments were repeated at least 4 times at each group for two cell lines, separately. In order to compare the results, several indicators such as treatment efficiency, synergistic ratio, and the amount of optical exposure required for 50% cell death (ED50) were also defined. Finally, SPSS 20 software is used for statistical analysis of data. RESULTS Pretreatment with CAP could significantly reduce cell survival in both cell lines (P<0.05). Also concentrations, irradiation time with CAP, and appropriate light exposure in both cell lines increased therapeutic efficiency compared to either treatment alone (P<0.05). While increasing the efficiency of photodynamic therapy varied between the two cell lines, the improvement in the PDT process was demonstrated by pretreatment with CAP. CONCLUSION Synergistic effect in the cell death with PDT were observed following He-CAP treatment and the results indicated that pretreatment with He-CAP improves the efficiency of photodynamic therapy.
Collapse
|
3
|
Liu D, Zhao S, Li J, Chen M, Wu L. The application of physical pretreatment in photodynamic therapy for skin diseases. Lasers Med Sci 2021; 36:1369-1377. [PMID: 33404884 DOI: 10.1007/s10103-020-03233-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 12/22/2020] [Indexed: 01/22/2023]
Abstract
Photodynamic therapy (PDT) is widely used in skin diseases; the response rate of PDT treatment varies widely. The limited penetration in the tissue of photosensitizers influenced the penetration depth of PDT, which obviously impacts the therapeutic effect. The studies have improved the efficacy of PDT through various pretreatment applications; especially, the physical pretreatment had achieved significant outcomes. We will review the physical pretreatment to optimize the efficacy of PDT in skin diseases by searching the literature on this topic. The types of physical pretreatment commonly used in the clinical practice are discussed: curettage, superficial shaving, laser, surgical resection, plum-blossom needles, and microneedles. Compared with PDT alone, the physical pretreatment before PDT application was generally improved the efficacy and reduced the recurrence, especially in actinic keratoses (AK), Bowen disease (BD), basal cell carcinoma (BCC), and viral warts. The application of the physical pretreatments before PDT may improve the efficacy of PDT in various skin diseases. However, each kind of physical pretreatment has the benefit and shortcoming, and the applicable situation is different.
Collapse
Affiliation(s)
- Dihui Liu
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.,Department of Dermatology, Guangzhou Integrated Traditional Chinese and Western Medicine Hospital, 87 Yingbin Avenue, Huadu District, Guangzhou, 510800, Guangdong, China
| | - Shuang Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Jinmao Li
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Mingliang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
| | - Lisha Wu
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China. .,Institute of Medical Sciences, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
| |
Collapse
|
4
|
An JH, Shin JU, Kim HJ, Lee HJ, Yoon MS, Kim DH. Comparison of the Treatment Outcomes of Photodynamic Therapy and Ingenol Mebutate in Bowen's Disease: A Retrospective Observational Study. Ann Dermatol 2020; 32:47-52. [PMID: 33911708 PMCID: PMC7992644 DOI: 10.5021/ad.2020.32.1.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/05/2019] [Accepted: 11/09/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ji Hae An
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jung U Shin
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Hyun Jung Kim
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Hee Jung Lee
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Moon Soo Yoon
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Dong Hyun Kim
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| |
Collapse
|
5
|
Liew Y, De Souza N, Sultana R, Oh C. Photodynamic therapy for the prevention and treatment of actinic keratosis/squamous cell carcinoma in solid organ transplant recipients: a systematic review and meta‐analysis. J Eur Acad Dermatol Venereol 2019; 34:251-259. [DOI: 10.1111/jdv.15852] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 06/27/2019] [Indexed: 01/05/2023]
Affiliation(s)
- Y.C.C. Liew
- Department of Dermatology Singapore General Hospital Singapore City Singapore
| | - N.N.A. De Souza
- Singapore Clinical Research Institute Singapore City Singapore
- Centre of Quantitative Medicine Duke‐NUS Graduate Medical School Singapore City Singapore
| | - R.G. Sultana
- Centre of Quantitative Medicine Duke‐NUS Graduate Medical School Singapore City Singapore
| | - C.C. Oh
- Department of Dermatology Singapore General Hospital Singapore City Singapore
| |
Collapse
|
6
|
Nguyen K, Khachemoune A. An update on topical photodynamic therapy for clinical dermatologists. J DERMATOL TREAT 2019; 30:732-744. [DOI: 10.1080/09546634.2019.1569752] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Khoa Nguyen
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Amor Khachemoune
- Veterans Affairs Medical Center, Brooklyn, NY, USA
- Department of Dermatology, SUNY Downstate, Brooklyn, NY, USA
| |
Collapse
|
7
|
Gómez C, Cobos M, Alberdi E. Methyl aminolevulinate-based photodynamic therapy of Bowen´s disease: Observational study of 21 lesions. Photodiagnosis Photodyn Ther 2019; 26:295-299. [PMID: 30986539 DOI: 10.1016/j.pdpdt.2019.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/01/2019] [Accepted: 04/10/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Although surgical removal is the treatment of choice in Bowen's disease (BD), there are cases in which by age, comorbidities, use of anticoagulants, location, cosmetic result, or size, it is preferable to use other treatments such as cryotherapy, 5-fluorouracil cream, imiquimod 5% cream or photodynamic therapy (PDT). Efficacy of PDT in BD is supported by substantial research and clinical data. OBJECTIVES This study aimed to evaluate the long term effectiveness of methyl aminolevulinate-PDT (MAL/PDT) on a wide range of Bowen lesions in different locations and sizes. METHODS Patients diagnosed with BD were treated in 3 sessions with a 4-week interval in between with MAL/PDT between January 2016 and January 2017 in a private clinic. Clinical response and relevant patient and tumour characteristics were analyzed during the first year after start of the PDT sessions. RESULTS In total, 21 BD lesions in 18 patients were included in the study. Complete regression (CR) after 3rd PDT session was 87.5% and 100% at the 6-month follow-up. Treatment was well tolerated and local adverse reactions were very scarce. No recurrence was observed at 12-month follow-up. Cosmetic outcome at 12 months was good or excellent in 100% of patients. CONCLUSIONS MAL/PDT is an effective, non invasive and safe treatment modality for BD with excellent cosmesis.
Collapse
Affiliation(s)
- Clara Gómez
- Institute of Physical Chemistry Rocasolano, Spanish National Research Council, CSIC, Madrid, Spain.
| | | | | |
Collapse
|
8
|
O’Connell KA, Okhovat JP, Zeitouni NC. Photodynamic therapy for Bowen’s Disease (squamous cell carcinoma in situ) current review and update. Photodiagnosis Photodyn Ther 2018; 24:109-114. [DOI: 10.1016/j.pdpdt.2018.09.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/05/2018] [Accepted: 09/17/2018] [Indexed: 01/08/2023]
|
9
|
Kim HJ, Song KH. Ablative fractional laser–assisted photodynamic therapy provides superior long-term efficacy compared with standard methyl aminolevulinate photodynamic therapy for lower extremity Bowen disease. J Am Acad Dermatol 2018; 79:860-868. [DOI: 10.1016/j.jaad.2018.05.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/01/2018] [Accepted: 05/20/2018] [Indexed: 11/27/2022]
|
10
|
Vignion-Dewalle AS, Baert G, Thecua E, Lecomte F, Vicentini C, Abi-Rached H, Mortier L, Mordon S. Comparison of 10 efficient protocols for photodynamic therapy of actinic keratosis: How relevant are effective light dose and local damage in predicting the complete response rate at 3 months? Lasers Surg Med 2018; 50:576-589. [PMID: 29667728 DOI: 10.1002/lsm.22827] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Topical photodynamic therapy is an established treatment modality for various dermatological conditions, including actinic keratosis. In Europe, the approved protocols for photodynamic therapy of actinic keratosis involve irradiation with either an Aktilite CL 128 lamp or daylight, whereas irradiation with the Blu-U illuminator is approved in the United States. Many other protocols using irradiation by a variety of light sources are also clinically efficient. OBJECTIVES This paper aims to compare 10 different protocols with clinically proven efficacy for photodynamic therapy of actinic keratosis and the available spectral irradiance of the light source. Effective irradiance, effective light dose, and local damage are compared. We also investigate whether there is an association between the complete response rate at 3 months and the effective light dose or local damage. METHODS The effective irradiance, also referred to as protoporphyrin IX-weighted irradiance, is obtained by integrating the spectral irradiance weighted by the normalized absorption spectrum of protoporphyrin IX over the wavelength. Integrating the effective irradiance over the irradiation time yields the effective light dose, which is also known as the protoporphyrin IX-weighted light dose. Local damage, defined as the total cumulative singlet oxygen molecules produced during treatment, is estimated using mathematical modeling of the photodynamic therapy process. This modeling is based on an iterative procedure taking into account the spatial and temporal variations in the protoporphyrin IX absorption spectrum during treatment. RESULTS The protocol for daylight photodynamic therapy on a clear sunny day, the protocol for daylight photodynamic therapy on an overcast day, the photodynamic therapy protocol for a white LED lamp for operating rooms and the photodynamic therapy protocol for the Blu-U illuminator perform better than the six other protocols-all involving red light illumination-in terms of both effective light dose and local damage. However, no association between the complete response rate at 3 months and the effective light dose or local damage was found. CONCLUSIONS Protocols that achieve high complete response rates at 3 months and low pain scores should be preferred regardless of the effective light dose and local damage. Lasers Surg. Med. 50:576-589, 2018. © 2018 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Anne-Sophie Vignion-Dewalle
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| | - Gregory Baert
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| | - Elise Thecua
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| | - Fabienne Lecomte
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| | - Claire Vicentini
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France.,Department of Dermatology, CHU Lille, Lille, F-5900, France
| | - Henry Abi-Rached
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France.,Department of Dermatology, CHU Lille, Lille, F-5900, France
| | - Laurent Mortier
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France.,Department of Dermatology, CHU Lille, Lille, F-5900, France
| | - Serge Mordon
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| |
Collapse
|
11
|
Campana LG, Marconato R, Valpione S, Galuppo S, Alaibac M, Rossi CR, Mocellin S. Basal cell carcinoma: 10-year experience with electrochemotherapy. J Transl Med 2017; 15:122. [PMID: 28569161 PMCID: PMC5452531 DOI: 10.1186/s12967-017-1225-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 05/27/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Electrochemotherapy (ECT), by combining manageable cytotoxic agents with short electric pulses, represents an effective palliative skin-directed therapy. The accumulated evidence indicates that ECT stands out as a safe and well-tolerated alternative treatment for patients with multiple or large basal cell carcinoma (BCC), who are not suitable for conventional treatments. However, long-term data and shared indications are lacking. METHODS In this observational study, we retrospectively analyzed 84 prospectively collected patients with multiple, recurrent or locally advanced BCC who were not candidate for standard therapies and received bleomycin-based ECT according to the European Standard Operative Procedures of ECT, from 2006 to 2016. RESULTS Disease extent was local, locally advanced and metastatic in 40 (48%), 41 (49%) and 3 (3%), respectively. Forty-four (52%) individuals had multiple BCCs. Grade 3 skin toxicity after ECT was observed in 6% of cases. Clearance rate was 50% (95% CI 39-61%). Primary presentation (p = 0.004), tumor size <3 cm (p < 0.001), well-defined borders (p = 0.021), absence of tumor ulceration (p = 0.001), non-aggressive BCC histology (p = 0.046) and age ≤69 years were associated with higher complete response rate. In patients with local BCC, the clearance rate was 72.5 and 85% after one or two ECT cycles, respectively. In the laBCC group, 32 patients (78%) achieved an objective response. Five-year recurrence rate for local and laBCC was 20 and 38%, respectively (p ≤ 0.001). CONCLUSIONS One or two ECT cycles with bleomycin may be a valuable palliative treatment in well-selected patients with multiple BCCs and favorable tumor features. Validation of predictive factors will be imperative to match patients with optimal ECT treatment modalities. Management of laBCC with ECT warrants further investigation. Trial registration ISRCTN14633165 Registered 24 March 2017 (retrospectively registered).
Collapse
Affiliation(s)
- Luca G Campana
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, Padua, Italy. .,Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128, Padua, Italy.
| | | | - Sara Valpione
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, Padua, Italy.,Christie NHS Foundation Trust, Manchester, M20 4BX, UK
| | - Sara Galuppo
- Radiotherapy Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Mauro Alaibac
- Dermatology Unit, University of Padova, Padua, Italy
| | - Carlo R Rossi
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, Padua, Italy.,Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128, Padua, Italy
| | - Simone Mocellin
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, Padua, Italy.,Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128, Padua, Italy
| |
Collapse
|
12
|
Zaar O, Fougelberg J, Hermansson A, Gillstedt M, Wennberg-Larkö AM, Paoli J. Effectiveness of photodynamic therapy in Bowen's disease: a retrospective observational study in 423 lesions. J Eur Acad Dermatol Venereol 2017; 31:1289-1294. [PMID: 28190258 DOI: 10.1111/jdv.14164] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/30/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is a well-known technique that is often used for treating superficial precancerous and cancerous skin lesions. However, only a handful of studies, with a relatively small number of treated lesions, have been carried out on the effectiveness of PDT for Bowen's disease (BD). OBJECTIVES This study aimed to assess the effectiveness and recurrence risk of PDT in the treatment of BD. The secondary objectives were to determine what factors affected the response rates and the cosmetic result of the treatment. METHOD In this retrospective observational study, the electronic patient charts at Sahlgrenska University Hospital (SUH) in Gothenburg, Sweden, were searched to find all patients diagnosed with BD who were treated with PDT between 1 January 2002 and 31 December 2014. Data were collected regarding clinical response at the first follow-up visit, recurrences during later follow-up visits and other relevant patient and tumour characteristics. RESULTS In total, 423 BD lesions in 335 patients were included in the study. The mean FU duration was 11.2 months (range 0.2-151 months). The complete response rate at the first FU visit was 77.5% for all BD lesions. During later FU visits, another 60 recurrences were observed, which resulted in a recurrence rate of 18.3%. Thus, the overall clearance rate after FU was 63.4% for all BD lesions. Significant risk factors for unsuccessful treatment in this study were large lesion size (>2 cm) and a single PDT session. CONCLUSION This study shows that PDT is a relatively effective treatment modality for BD.
Collapse
Affiliation(s)
- O Zaar
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - J Fougelberg
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Hermansson
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - M Gillstedt
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A-M Wennberg-Larkö
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - J Paoli
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
13
|
Rollakanti K, Anand S, Maytin EV. Topical calcitriol prior to photodynamic therapy enhances treatment efficacy in non-melanoma skin cancer mouse models. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2015; 9308:93080Q. [PMID: 25983370 DOI: 10.1117/12.2077296] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Non-melanoma skin cancers (NMSCs) such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common form of human cancer worldwide, and their incidence is increasing. Photodynamic therapy (PDT), mediated by topically applied aminolevulinic acid (ALA) and subsequent exposure to light (either a laser or a noncoherent source), is being increasingly used for the treatment of dermatological disorders, including BCC and SCC. However, therapeutic responses of NMSCs to ALA-PDT are currently not superior to standard therapies, although the latter have undesirable side effects including scarring. In this study, we report that preconditioning of skin tumors with calcitriol (active form of Vitamin D; Vit D) prior to ALA-PDT, significantly improves the treatment outcome. In BCC and UVB-induced SCC mouse models, we identified an increase in tumor-specific accumulation of ALA induced photosensitizer (protoporphyrin IX, PpIX) due to Vit D preconditioning, of up to 6-fold in vivo. In addition, increased expression of differentiation (145 fold, p < 0.02) and proliferation (42 fold, p < 0.005) markers were identified in BCC tumors, all leading to increased tumor destruction (18.3 fold, p < 0.03) with the combination approach, as compared to ALA-PDT alone. Histomorphological changes identified using hematoxylin and eosin staining, and results of TUNEL staining, together documented a beneficial effect of Vit D pretreatment upon tumor cell death. We conclude that this new combination approach with Vit D and ALA-PDT has great potential to achieve complete remission of NMSC tumors, with excellent cosmetic results and an overall beneficial impact upon patient care.
Collapse
Affiliation(s)
- Kishore Rollakanti
- Department of Chemical and Biomedical Engineering, Cleveland State University, 2121 Euclid Avenue, Cleveland, OH, USA 44115 ; Department of Biomedical Engineering, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA 44195
| | - Sanjay Anand
- Department of Biomedical Engineering, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA 44195 ; Department of Dermatology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA 44195
| | - Edward V Maytin
- Department of Chemical and Biomedical Engineering, Cleveland State University, 2121 Euclid Avenue, Cleveland, OH, USA 44115 ; Department of Biomedical Engineering, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA 44195 ; Department of Dermatology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA 44195
| |
Collapse
|
14
|
Shiao YS, Chiu HH, Wu PH, Huang YF. Aptamer-functionalized gold nanoparticles as photoresponsive nanoplatform for co-drug delivery. ACS APPLIED MATERIALS & INTERFACES 2014; 6:21832-41. [PMID: 24949657 DOI: 10.1021/am5026243] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Various platforms have been developed as innovative nanocarriers to deliver therapeutic agents to the diseased sites. Multifunctional surface modification allows an enhanced recognition and uptake of drug carriers by targeted cells. However, the development of drug resistance in some tumor cells plays a major role in the failure of chemotherapy. Drugs given in combination, called multidrug delivery approach, was designed to improve the therapeutic efficacy and has become an increasingly used strategy that is of great importance in clinical cancer treatments. In this study, aptamer-functionalized gold nanoparticles (Au NPs) have been used as a nanoplatform to codeliver two different anticancer drugs for improving the drug effectiveness. The surface of Au NPs (13 nm in diameter) was assembled with AS1411 aptamers, which tethered with 21-base pairs of (CGATCGA)3 sequence approached to the Au NPs. Both the photosensitizer 5,10,15,20-tetrakis(1-methylpyridinium-4-yl) porphyrin (TMPyP4) and the chemotherapeutic drug doxorubicin (Dox) were then physically attached to the AS1411-conjugated Au NPs (T/D:ds-NPs) and delivered to the target tumor cells such as HeLa and Dox-resistant MCF-7R cell lines. When exposed to a 632 nm light, reactive oxygen species induced by TMPyP4 molecules were generated inside the living cells, followed by cell damage. In addition, triggered release of the complementary drugs also occurred simultaneously during the photodynamic reaction. In the presence of Dox molecules, the toxicity toward the target cells was superior to individual drug treatment. Overall, a co-drug delivery platform was successfully established to improve the therapeutic efficacy in tumor cells. The improvement of the photodynamic-stimulated triggered release was enhanced, thus highly promising precise drug release in targeted drug delivery.
Collapse
Affiliation(s)
- Yi-Syun Shiao
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University , Hsinchu, Taiwan ROC
| | | | | | | |
Collapse
|
15
|
A plant-derived anti-nociceptive spray for reduction of pain with photodynamic therapy. Photodiagnosis Photodyn Ther 2014; 11:467-71. [DOI: 10.1016/j.pdpdt.2014.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Revised: 10/19/2014] [Accepted: 10/21/2014] [Indexed: 01/30/2023]
|
16
|
Westers-Attema A, Lohman BG, van den Heijkant F, Nelemans PJ, Winnepenninckx VJ, Kelleners-Smeets NW, Mosterd K. Photodynamic Therapy in Bowen's Disease: Influence of Histological Features and Clinical Characteristics on Its Success. Dermatology 2014; 230:55-61. [DOI: 10.1159/000366500] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 08/07/2014] [Indexed: 11/19/2022] Open
|
17
|
Buinauskaite E, Maciulaitis R, Buinauskiene J, Valiukeviciene S. Topical photodynamic therapy of actinic keratoses with 5-aminolevulinic acid: Randomized controlled trial with six months follow-up. J DERMATOL TREAT 2013; 25:519-22. [DOI: 10.3109/09546634.2013.848257] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
18
|
Hassan KM, Benedetto AV. Facial skin rejuvenation: Ablative laser resurfacing, chemical peels, or photodynamic therapy? Facts and controversies. Clin Dermatol 2013; 31:737-40. [DOI: 10.1016/j.clindermatol.2013.05.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
19
|
Lallas A, Argenziano G, Zendri E, Moscarella E, Longo C, Grenzi L, Pellacani G, Zalaudek I. Update on non-melanoma skin cancer and the value of dermoscopy in its diagnosis and treatment monitoring. Expert Rev Anticancer Ther 2013; 13:541-58. [PMID: 23617346 DOI: 10.1586/era.13.38] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Dermoscopy has become an integrative part of the clinical examination of skin tumors. This is because it significantly improves the early diagnosis of melanoma and non-melanoma skin cancer (NMSC) including basal cell carcinoma and keratinocyte skin cancer compared with the unaided eye. Besides its value in the noninvasive diagnosis of skin cancer, dermoscopy has also gained increased interest in the management of NMSC. Dermoscopy has been used in the preoperative evaluation of tumor margins, monitoring of the outcomes of topical treatments and post-treatment follow-up. This article provides an update on NMSC with special emphasis on dermoscopy in the diagnosis and management of basal cell carcinoma, actinic keratosis, Bowens' disease and squamous cell carcinoma.
Collapse
Affiliation(s)
- Aimilios Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Viale Risorgimento 80, 42100 Reggio Emilia, Italy
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Kim SK, Park JY, Song HS, Kim YS, Kim YC. Photodynamic therapy with ablative carbon dioxide fractional laser for treating Bowen disease. Ann Dermatol 2013; 25:335-9. [PMID: 24003277 PMCID: PMC3756199 DOI: 10.5021/ad.2013.25.3.335] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 07/05/2012] [Accepted: 08/26/2012] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Topical photodynamic therapy (PDT) has been increasingly used to treat malignant skin tumors including the Bowen disease. However, patients could be displeased with the long incubation time required for conventional PDT. OBJECTIVE We evaluated the efficacy and safety of PDT with a short incubation time of ablative CO2 fractional laser pretreatment for treating Bowen disease. METHODS Ten patients were included. Just before applying the topical photosensitizer, all lesions were treated with ablative CO2 fractional laser, following the application of methyl aminolevulinate and irradiation with red light (Aktilite CL 128). Histological confirmation, rebiopsy, and clinical assessments were performed. Adverse events were also recorded. RESULTS Five of the ten (50%) lesions showed a complete response (CR) within three PDT sessions. After four treatment sessions, all lesions except one penile shaft lesion (90%) achieved clinical and histological CR or clinical CR only. The average number of treatments to CR was 3.70±1.70. The treatments showed favorable cosmetic outcomes and no serious adverse events. CONCLUSION The results suggest that pretreatment with an ablative fractional CO2 laser before PDT has similar treatment efficacy and requires a shorter photosensitizer incubation time compared with the conventional PDT method.
Collapse
Affiliation(s)
- Sue Kyung Kim
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
| | | | | | | | | |
Collapse
|
21
|
Tehranchinia Z, Rahimi H, Ahadi MS, Ahadi MS. Aminolevulinic Acid-photodynamic therapy of Basal cell carcinoma and factors affecting the response to treatment: a clinical trial. Indian J Dermatol 2013; 58:327. [PMID: 23919025 PMCID: PMC3726902 DOI: 10.4103/0019-5154.113968] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background: Basal cell carcinoma (BCC) is the most common type of skin cancer in humans. Photodynamic therapy (PDT) is a non-invasive therapeutic modality that may be considered as a valuable treatment option for BCC. This study was designed with the aim of evaluating the efficacy of PDT in treatment of BCC and factors that may affect the response rate. Materials and Methods: This clinical trial was conducted on 12 patients (28 BCC lesions) who were treated with aminulevulinic acid (ALA)-PDT, monthly, up to 6 sessions and the clinical response, cosmetic results, and possible side effects were evaluated. Results: The study was performed on 28 BCC lesions from 12 patients. Complete response was achieved in 9 (32.1%) lesions. Complete response rate was higher in younger patients (P < 0.01) and those with smaller lesions (P < 0.001). Superficial type also had significant higher response rate (P < 0.05). Patients with history of radiotherapy for the treatment of tinea capitis in childhood showed less response (P < 0.05). Cosmetic results were excellent or good in 77.5% cases. After 6 months of follow-up, none of the resolved lesions recurred. Conclusion: PDT would be a good therapeutic option in treatment of BCC with acceptable efficacy and low side effects. Younger patients, superficial BCCs, and smaller lesions show better response to ALA-PDT. History of radiotherapy may be associated with a lower response rate.
Collapse
Affiliation(s)
- Zohreh Tehranchinia
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Sydney, Iran
| | | | | | | |
Collapse
|
22
|
Qian G, Wang S, Deng D, Yang G. Is the step-up therapy of topical 5-aminolevulinic acid photodynamic therapy effective and safe for the patients with recalcitrant facial flat wart? Dermatol Ther 2013; 27:83-8. [PMID: 24703264 DOI: 10.1111/dth.12060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Facial flat wart, caused by human papilloma virus type 3 and less often, type 10, 27, and 41, often brings many cosmetic problems to children and young adults. Considering the disturbing cosmetic problem, the treatment of facial flat wart is always frustrating and often unsuccessful, although there are many treatment modalities. Considering the possible serious side effects of 5-aminolevulinic acid photodynamic therapy (ALA-PDT), we designed step-up therapy of ALA-PDT on different clinical phases of facial flat wart. As a new protocol of ALA-PDT, we found the step-up therapy of ALA-PDT could also receive excellent effects with the lower side effects. Meanwhile, the tolerance of patients to ALA-PDT could improve with subsequent treatment sessions and escalating doses of ALA-PDT.
Collapse
Affiliation(s)
- Ge Qian
- Department of Dermatology and Venereology, The 2nd Affiliated Hospital of Kunming Medical University, Kunming, China
| | | | | | | |
Collapse
|
23
|
Passos SK, de Souza PE, Soares PK, Eid DR, Primo FL, Tedesco AC, Lacava ZG, Morais PC. Quantitative approach to skin field cancerization using a nanoencapsulated photodynamic therapy agent: a pilot study. Clin Cosmet Investig Dermatol 2013; 6:51-9. [PMID: 23450821 PMCID: PMC3581285 DOI: 10.2147/ccid.s36758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background This paper introduces a new nanoformulation of 5-aminolevulinic acid (nano-ALA) as well as a novel quantitative approach towards evaluating field cancerization for actinic keratosis and/or skin photodamage. In this pilot study, we evaluated field cancerization using nano-ALA and methyl aminolevulinate (MAL), the latter being commercialized as Metvix®. Methods and results Photodynamic therapy was used for the treatment of patients with selected skin lesions, whereas the fluorescence of the corresponding photosensitizer was used to evaluate the time evolution of field cancerization in a quantitative way. Field cancerization was quantified using newly developed color image segmentation software. Using photodynamic therapy as the precancer skin treatment and the approach introduced herein for evaluation of fluorescent area, we found that the half-life of field cancerization reduction was 43.3 days and 34.3 days for nano-ALA and MAL, respectively. We also found that nano-ALA targeted about 45% more skin lesion areas than MAL. Further, we found the mean reduction in area of skin field cancerization was about 10% greater for nano-ALA than for MAL. Conclusion Although preliminary, our findings indicate that the efficacy of nano-ALA in treating skin field cancerization is higher than that of MAL.
Collapse
Affiliation(s)
- Simone K Passos
- University of Brasília, Institute of Biological Sciences, DF, Brazil ; Foundation for Teaching and Research on Health Sciences, Brasília, DF, Brazil
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Valentine RM, Wood K, Brown CTA, Ibbotson SH, Moseley H. Monte Carlo simulations for optimal light delivery in photodynamic therapy of non-melanoma skin cancer. Phys Med Biol 2012; 57:6327-45. [DOI: 10.1088/0031-9155/57/20/6327] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
25
|
Terapia fotodinámica versus imiquimod. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:488-501. [DOI: 10.1016/j.ad.2011.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 09/27/2011] [Accepted: 10/02/2011] [Indexed: 11/22/2022] Open
|
26
|
Serra-Guillén C, Nagore E, Guillén C. Photodynamic Therapy vs Imiquimod. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2012.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
27
|
Montazerabadi AR, Sazgarnia A, Bahreyni-Toosi MH, Ahmadi A, Shakeri-Zadeh A, Aledavood A. Mitoxantrone as a prospective photosensitizer for photodynamic therapy of breast cancer. Photodiagnosis Photodyn Ther 2012; 9:46-51. [DOI: 10.1016/j.pdpdt.2011.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Revised: 08/20/2011] [Accepted: 08/23/2011] [Indexed: 01/19/2023]
|
28
|
Montazerabadi AR, Sazgarnia A, Bahreyni-Toosi MH, Ahmadi A, Aledavood A. The effects of combined treatment with ionizing radiation and indocyanine green-mediated photodynamic therapy on breast cancer cells. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2012; 109:42-9. [PMID: 22325306 DOI: 10.1016/j.jphotobiol.2012.01.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 01/17/2012] [Accepted: 01/19/2012] [Indexed: 12/27/2022]
Abstract
This study was undertaken to evaluate the effects of indocyanine green as a sensitizer in both photodynamic and radiation therapy on MCF-7 human breast cancer cells line. The cells were incubated with indocyanine green at different concentrations for 24h and were then exposed in the independent treatment groups to a non-coherent light at different fluence rates and X-ray ionizing radiation at different dose rates. In addition, combination effects of this chemo, photo, and radiotherapy were evaluated. The percentage of the cell survival was investigated using the MTT assay. The results showed that indocyanine green had no significant cytotoxic effects up to 100 μM but as a photosensitizer had a strong cytotoxic effect on cancer cells. Despite, indocyanine green could not act as a radiosensitizer. Furthermore, it is surprising to find that 50 μM of indocyanine green in combination with light at 60 J/cm(2) and 4 Gy of X-ray radiation astonishingly killed cancer cells and reduced the percentage of viable cancer cells to be 3.42%. According to the findings, we observed the same efficacy of treatment by adding a low dose of radiation and reducing light fluence rate. In fact, it appears from our data that the adverse effects of photodynamic therapy can be partially abated without reducing the efficacy of treatment. Obviously, this new therapeutic avenue in breast cancer therapy could be worth further investigation and elucidation and should be tested in vivo models for being applied in human therapy.
Collapse
|
29
|
Brightman L, Warycha M, Anolik R, Geronemus R. Do lasers or topicals really work for nonmelanoma skin cancers? ACTA ACUST UNITED AC 2011; 30:14-25. [PMID: 21540017 DOI: 10.1016/j.sder.2011.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Novel strategies are urgently needed to address the millions of nonmelanoma skin cancers treated in the United States annually. The need is greatest for those patients who are poor surgical candidates or those prone to numerous nonmelanoma skin cancers and therefore at risk for marked disfigurement. Traditional treatment strategies include electrosurgery with curettage, radiation therapy, cryotherapy, excision, and Mohs micrographic surgery. Alternatives to traditional treatment, including topical medications and light or laser therapies, are becoming popular; however, there are various degrees of efficacy among these alternative tactics. These alternatives include topical retinoids, peels, 5-fluorouracil, imiquimod, photodynamic therapy, and lasers. The purpose of this paper is to review the available data regarding these alternative strategies and permit the reader to have a sense of which therapies are reasonable options for care.
Collapse
Affiliation(s)
- Lori Brightman
- Laser & Skin Surgery Center of New York, 317 East 34th Street New York, NY 10016, USA.
| | | | | | | |
Collapse
|
30
|
Shimizu I, Cruz A, Chang KH, Dufresne RG. Treatment of Squamous Cell Carcinoma In Situ: A Review. Dermatol Surg 2011; 37:1394-411. [DOI: 10.1111/j.1524-4725.2011.02088.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
31
|
Prado R, Francis SO, Mason MN, Wing G, Gamble RG, Dellavalle R. Nonmelanoma skin cancer chemoprevention. Dermatol Surg 2011; 37:1566-78. [PMID: 21895847 DOI: 10.1111/j.1524-4725.2011.02108.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Renata Prado
- Department of Dermatology, School of Medicine, University of Colorado, Aurora, Colorado, USA.
| | | | | | | | | | | |
Collapse
|
32
|
Truchuelo M, Fernández-Guarino M, Fleta B, Alcántara J, Jaén P. Effectiveness of photodynamic therapy in Bowen's disease: an observational and descriptive study in 51 lesions. J Eur Acad Dermatol Venereol 2011; 26:868-74. [PMID: 21740466 DOI: 10.1111/j.1468-3083.2011.04175.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Bowen disease (BD) or squamous cell carcinoma (SCC) in situ affects both skin and mucous membranes and has the potential to progress to invasive SCC. Photodynamic therapy (PDT) has been approved recently for the treatment of BD. Some studies have demonstrated its efficacy and good cosmetic outcome. OBJECTIVE To assess the efficacy of PDT in the treatment of BD. PATIENTS AND METHODS We carried out an observational, retrospective and descriptive study. A total of 47 patients with 51 lesions of BD were included. All the lesions were confirmed with previous cutaneous biopsy. All patients were treated with the standard protocol. Topical methyl-aminolaevulinic acid was occluded during 3 h and followed by illumination with red-light (630 nm, 38 J/cm2, 7.5 min). Clinical and fluorescence photographs images were taken before each session. All patients received two sessions one week apart. Clinical response was classified in partial or complete response. Fluorescence response was classified in negative, intermediate or intense. The follow-up period and the adverse events observed including pain were also collected. RESULTS A total of 20 men and 27 women with a mean age of 75.57 years old were treated with PDT. Lesions were most frequently located in the lower limbs. Globally, 76.09% of the lesions achieved complete response after 2 sessions with a medium follow-up of 16.61 months. Fluorescence of the lesions disappeared when clinical response was achieved, but not always. The most common adverse effect was an immediate burning sensation. All lesions showed an excellent cosmetic result. CONCLUSION Photodynamic therapy is an effective treatment for BD in terms of both clinical remission and cosmetic results, with good tolerance and minimal adverse effects.
Collapse
|
33
|
Nakano A, Watanabe D, Akita Y, Kawamura T, Tamada Y, Matsumoto Y. Treatment efficiency of combining photodynamic therapy and ionizing radiation for Bowen’s disease. J Eur Acad Dermatol Venereol 2011; 25:475-8. [DOI: 10.1111/j.1468-3083.2010.03757.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
34
|
Photosensitizers and light sources for photodynamic therapy of the Bowen’s disease. Arch Dermatol Res 2011; 303:145-51. [DOI: 10.1007/s00403-011-1122-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Revised: 12/27/2010] [Accepted: 01/11/2011] [Indexed: 11/27/2022]
|
35
|
Neves DR, Ramos DG, Magalhães GM, Rodrigues RDC, Souza JBAD. Terapia fotodinâmica para tratamento de múltiplas lesões no couro cabeludo na síndrome do nevobasocelular: relato de caso. An Bras Dermatol 2010; 85:545-8. [DOI: 10.1590/s0365-05962010000400019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2008] [Accepted: 01/29/2010] [Indexed: 11/22/2022] Open
Abstract
A terapia fotodinâmica é uma alternativa eficaz de tratamento para neoplasias cutâneas não melanoma e tem como princípio a utilização de substâncias fotossensibilizantes que, após serem irradiadas com uma fonte de luz de comprimento de onda adequado, destroem seletivamente as células neoplásicas. A Síndrome do Nevobasocelular é uma genodermatose que cursa com o desenvolvimento de inúmeros carcinomas basocelulares em uma idade precoce, submetendo os pacientes a vários procedimentos cirúrgicos, muitas vezes desfigurantes. Este artigo tem como objetivo demonstrar o excelente resultado do tratamento de carcinomas basocelulares no couro cabeludo de uma paciente com a Síndrome do Nevobasocelular.
Collapse
|
36
|
Babilas P, Schreml S, Landthaler M, Szeimies RM. Photodynamic therapy in dermatology: state-of-the-art. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2010; 26:118-32. [DOI: 10.1111/j.1600-0781.2010.00507.x] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
37
|
Reichrath J. Dermatologic management, sun avoidance and vitamin D status in organ transplant recipients (OTR). JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2010; 101:150-9. [PMID: 20434355 DOI: 10.1016/j.jphotobiol.2010.04.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Revised: 02/15/2010] [Accepted: 04/01/2010] [Indexed: 11/25/2022]
Abstract
It is well known that skin cancer, especially cutaneous squamous cell carcinoma (SCC), in organ transplant recipients (OTRs) has higher incidence rates, behaves more aggressively and has higher rates of metastasis. OTRs who have been treated for many years with immunosuppressive medication are at the highest risk for developing malignant skin tumors. Protection against solar and artificial UV-radiation is crucial to prevent skin cancer in OTRs. However, investigations have revealed that solar UV-B-exposure and serum 25(OH)D levels positively correlate with decreased risk for various internal malignancies (e.g. breast, colon, prostate, and ovarian cancer) and other severe diseases. Therefore, it is important to detect and treat vitamin D deficiency in OTRs. This review discusses guidelines for the optimal management of these patients, that require communication between the transplant teams, the treating dermatologist and other clinicians.
Collapse
Affiliation(s)
- Jörg Reichrath
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, D-66421 Homburg/Saar, Germany.
| |
Collapse
|
38
|
Willey A, Mehta S, Lee PK. Reduction in the incidence of squamous cell carcinoma in solid organ transplant recipients treated with cyclic photodynamic therapy. Dermatol Surg 2009; 36:652-8. [PMID: 19889154 DOI: 10.1111/j.1524-4725.2009.01384.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVES Squamous cell carcinomas (SCCs) produce significant morbidity in solid organ transplant recipients (SOTRs), particularly in patients who develop multiple tumors. Topical photodynamic therapy (PDT) has been shown to decrease the number of keratotic lesions in SOTRs, but the duration of the beneficial effect is limited. The aim of this study was to evaluate the potential benefit of cyclic PDT in the prevention of new SCCs in SOTRs. METHODS Twelve high-risk SOTRs received cyclic PDT treatments at 4- to 8-week intervals for 2 years. The development of new SCCs (invasive and in situ) performed 12 and 24 months after the start of cyclic PDT were compared with the number of SCCs developed during the year before initiation of cyclic PDT. RESULTS The median reduction in the 12- and 24-month post-treatment counts from the 1-month pretreatment counts was 79.0% (73.3-81.8%) and 95.0% (87.5-100.0%), respectively. Treatments were well tolerated. CONCLUSION Cyclic PDT with 5-aminolevulinic acid may reduce the incidence of SCC in SOTRs. Additional studies with larger numbers of patients and optimized protocols are necessary to further explore the potential benefits of cyclic PDT in the prevention of skin cancer in this high-risk patient population.
Collapse
Affiliation(s)
- Andrea Willey
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA.
| | | | | |
Collapse
|
39
|
Foley P, Freeman M, Menter A, Siller G, El-Azhary RA, Gebauer K, Lowe NJ, Jarratt MT, Murrell DF, Rich P, Pariser DM, Oseroff AR, Barnetson R, Anderson C, Kossard S, Gibson LE, Tope WD. Photodynamic therapy with methyl aminolevulinate for primary nodular basal cell carcinoma: results of two randomized studies. Int J Dermatol 2009; 48:1236-45. [DOI: 10.1111/j.1365-4632.2008.04022.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
40
|
Souza C, Felicio L, Ferreira J, Kurachi C, Bentley M, Tedesco A, Bagnato V. Long-term follow-up of topical 5-aminolaevulinic acid photodynamic therapy diode laser single session for non-melanoma skin cancer. Photodiagnosis Photodyn Ther 2009; 6:207-13. [DOI: 10.1016/j.pdpdt.2009.09.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Revised: 08/31/2009] [Accepted: 09/07/2009] [Indexed: 10/20/2022]
|
41
|
Basal cell carcinoma treated successfully with combined CO2 laser and photodynamic therapy in a renal transplant patient: a case report. CASES JOURNAL 2009; 2:7920. [PMID: 19918437 PMCID: PMC2769387 DOI: 10.4076/1757-1626-2-7920] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Accepted: 07/27/2009] [Indexed: 11/08/2022]
Abstract
Renal transplant recipients are at significantly greater risk of developing skin malignancies due to combination immunosuppressive therapy. A significant number of patients present with lesions needing excision at multiple outpatient follow-up visits. For basal cell carcinoma, we have recently described how combining CO2 laser with Photodynamic therapy greatly increases the efficacy of long-term tumour clearance compared with each modality alone. We present a case of a 66-year-old renal transplant therapy patient who repeatedly presents with new skin malignancies, in whom we treated successfully with Laser-Photodynamic therapy in a see-and-treat setting. This therapy offers patients the possibility of better cosmetic and functional results whilst obviating the need for repeated surgery. Other pre-cancerous lesions such as solar keratoses are prevalent in this patient group and respond extremely well to Photodynamic therapy monotherapy. We propose a regular clinic for renal transplant patients in a laser facility equipped with CO2 laser and Photodynamic therapy, histopathology and punch-biopsy materials. This strategy allows simple and effective treatment of multiple lesions simultaneously, avoidance of numerous operations, avoidance of non-essential outpatient appointments that result in booking furthers visits for treatment, whilst facilitating diagnostic biopsies of potentially malignant lesions. We outline a care pathway for a see-and-treat clinic that implements this novel treatment modality improving the care of this unique patient population.
Collapse
|
42
|
Choudhary S, Nouri K, Elsaie ML. Photodynamic therapy in dermatology: a review. Lasers Med Sci 2009; 24:971-80. [PMID: 19653060 DOI: 10.1007/s10103-009-0716-x] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 07/11/2009] [Indexed: 12/18/2022]
Abstract
Photodynamic therapy (PDT) is used for the prevention and treatment of non-melanoma skin cancer. Until recently, clinically approved indications have been restricted to actinic keratoses, nodular and superficial basal cell carcinoma, and, since 2006, Bowen disease. However, the range of indications has been expanding continuously. PDT is also used for the treatment of non-malignant conditions such as acne vulgaris and leishmaniasis, as well as for treating premature skin aging due to sun exposure. The production of reactive oxygen intermediates like singlet oxygen depends on the light dose applied as well as the concentration and localization of the photosensitizer in the diseased tissue. Either cytotoxic effects resulting in tumor destruction or immunomodulatory effects improving inflammatory skin conditions are induced. Treating superficial non-melanoma skin cancer, PDT has been shown to be highly efficient, despite the low level of invasiveness. The excellent cosmetic results after treatment are beneficial, too.
Collapse
Affiliation(s)
- Sonal Choudhary
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, FL, USA
| | | | | |
Collapse
|
43
|
Maladies de Bowen multiples des membres inférieurs chez les femmes âgées : une forme clinique particulière et de traitement difficile. Ann Dermatol Venereol 2009; 136:508-12. [DOI: 10.1016/j.annder.2009.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2008] [Accepted: 04/17/2009] [Indexed: 11/22/2022]
|
44
|
Tierney E, Barker A, Ahdout J, Hanke WC, Moy RL, Kouba DJ. Photodynamic Therapy for the Treatment of Cutaneous Neoplasia, Inflammatory Disorders, and Photoaging. Dermatol Surg 2009; 35:725-46. [DOI: 10.1111/j.1524-4725.2009.01117.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
45
|
Reichrath J, Nürnberg B. Solar UV-Radiation, Vitamin D and Skin Cancer Surveillance in Organ Transplant Recipients (OTRs). SUNLIGHT, VITAMIN D AND SKIN CANCER 2009; 624:203-14. [DOI: 10.1007/978-0-387-77574-6_16] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
46
|
Abstract
This article represents a planned regular updating of the previous British Association of Dermatologists guidelines for the management of basal cell carcinoma. These guidelines present evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of epidemiological aspects, diagnosis and investigation.
Collapse
Affiliation(s)
- N R Telfer
- Dermatology Centre, Salford Royal Hospitals NHS Foundation Trust, Manchester M6 8HD, UK.
| | | | | | | |
Collapse
|
47
|
Christensen E, Skogvoll E, Viset T, Warloe T, Sundstrøm S. Photodynamic therapy with 5-aminolaevulinic acid, dimethylsulfoxide and curettage in basal cell carcinoma: a 6-year clinical and histological follow-up. J Eur Acad Dermatol Venereol 2008; 23:58-66. [PMID: 18803580 DOI: 10.1111/j.1468-3083.2008.02946.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Long-term follow-up data are needed to evaluate treatment effect after photodynamic therapy (PDT). OBJECTIVE To investigate long-term clinical, histological and cosmetic follow-up results in basal cell carcinoma (BCC) after PDT, including treatment response related to patients and lesion characteristics. MATERIALS AND METHODS A longitudinal study of 44 patients with 60 histologically verified BCC tumours, treated with one or two sessions of dimethylsulfoxide (DMSO)-supported 5-aminolaevulinic acid--PDT following curettage, was performed. Lesions in complete remission after 3 months were followed with clinical inspection, histological investigation and evaluation of cosmetic outcome at regular intervals; long-term efficacy assessed as verified recurrence within 72 months after PDT. RESULTS Complete remission at 3 months was achieved in 55 lesions from 39 patients. Two patients with one lesion each died. At 72 months, 43 of 53 lesions remained disease-free (81%); 68% remained after one treatment session, and 91% remained after two treatment sessions. Recurrence of tumour occurred at 6, 12, 24 and 36 months in 2, 4, 2 and 2 lesions, respectively; clinical investigation identified 97% of them. Male sex and H-mid-face zone were significantly associated with recurrence. The cosmetic outcome at 72 months was rated as good or excellent by patients and investigators in more than 90% of evaluated cases. CONCLUSION DMSO-PDT following curettage is an effective treatment for BCC, with favourable long-term clinical, histopathological and cosmetic results. Clinical examination of treated lesions appears to be sufficient for long term follow up.
Collapse
Affiliation(s)
- E Christensen
- Department of Dermatology, St. Olav's University Hospital HF, Institute of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | | | | | | | | |
Collapse
|
48
|
Felício LBAD, Ferreira J, Bentley MVB, Bagnato VS, Tedesco CA, Souza CDS. A terapia fotodinâmica com ácido 5-aminolevulínico como modalidade de tratamento para neoplasias cutâneas não-melanoma. An Bras Dermatol 2008. [DOI: 10.1590/s0365-05962008000400004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
FUNDAMENTOS: A terapia fotodinâmica baseia-se na associação de fonte de luz e fotossensibilizador para destruir seletivamente as células. OBJETIVO: Avaliar os efeitos imediatos e tardios, a resposta clínica e os resultados estéticos da terapia fotodinâmica com ácido 5-aminolevulínico em neoplasias cutâneas não-melanoma. MÉTODOS: Trinta e quatro lesões, sendo 19 disceratoses de Bowen e 15 carcinomas basocelulares, foram submetidas à aplicação tópica e oclusiva do ácido 5-aminolevulínico a 20%, por seis horas, e posteriormente a sessão única de laser de diodo (630nm). RESULTADOS: Foram registrados: sensação de queimação durante as sessões; eritema, edema e erosões, nas primeiras 72 horas; cicatrização em média de quatro semanas; resultados estéticos variáveis de excelentes a bons. Aos três meses, a resposta clínica foi de 91,2%, sendo reduzida, aos 18 meses, para 73,3%, de modo similar tanto para disceratose de Bowen (72,2%) quanto para carcinoma basocelular (75%). Foi evidenciada relação de tendência linear entre a redução da freqüência da resposta clínica e o aumento da dimensão das neoplasias cutâneas não-melanoma (p<0,001). CONCLUSÃO: A terapia fotodinâmica com ácido 5-aminolevulínico tópico mostrou destacadas vantagens: minimamente invasiva no tratamento de lesões múltiplas em sessão única ou em sítios de pobre cicatrização com superioridade dos resultados estéticos. O tipo/subtipo(clínico e histopatológico), a dimensão e o adequado seguimento devem ser considerados para a sua indicação no tratamento de neoplasias cutâneas não-melanoma.
Collapse
|
49
|
MacCormack MA. Photodynamic Therapy in Dermatology: An Update on Applications and Outcomes. ACTA ACUST UNITED AC 2008; 27:52-62. [DOI: 10.1016/j.sder.2007.12.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
50
|
Stritt A, Merk HF, Braathen LR, von Felbert V. Photodynamic therapy in the treatment of actinic keratosis. Photochem Photobiol 2008; 84:388-98. [PMID: 18221454 DOI: 10.1111/j.1751-1097.2007.00276.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The efficacy of photodynamic therapy (PDT) with 5-aminolevulinate and methyl aminolevulinate in the treatment of actinic keratosis has been demonstrated in a large number of clinical studies over the last several years. Here, we recapitulate the major findings, comparing the various photosensitizers, light sources and therapeutic regimens, and present a retrospective analysis of 142 own cases treated with 259 PDTs. In addition, we also discuss the value of PDT in comparison with cryotherapy or 5-fluorouracil. The efficacy and the low risk of side effects of PDT have resulted in a high patient preference in clinical trials.
Collapse
Affiliation(s)
- Andrea Stritt
- Department of Dermatology, Inselspital, University of Bern, Bern, Switzerland
| | | | | | | |
Collapse
|