Abstract
Background Basal cell carcinoma (BCC) is the most common type of skin cancer and incidence rates are increasing. Photodynamic therapy (PDT) is a frequently used treatment, especially for superficial BCC (sBCC). Two topical photosensitizing agents are currently used to treat sBCC, namely 5-aminolaevulinic acid (ALA) and its ester, methyl aminolaevulinate (MAL). Previous research showed a high efficacy for ALA-PDT using a twofold fractionated illumination scheme in which two light fractions of 20 J cm(-2) and 80 J cm(-2) were delivered 4 h and 6 h after ALA application. Objectives To evaluate whether twofold ALA-PDT is superior to conventional MAL-PDT for sBCC. Methods We performed a single-blind, randomized, multicentre trial in the Netherlands. Results Overall, 162 patients were randomized either to conventional MAL-PDT or twofold ALA-PDT. After 12 months, a total of six treatment failures occurred following ALA-PDT and 13 treatment failures occurred following MAL-PDT. The 12-month cumulative probability of remaining free from treatment failure was 92.3% [95% confidence interval (CI) (83.7-96.5)] for ALA-PDT and 83.4% (95% CI 73.1-90.0) for MAL-PDT (P = 0.091). Conclusions The twofold ALA-PDT scheme resulted in fewer recurrences, although the difference between both treatment groups was not statistically significant. However, ALA-PDT resulted in higher pain scores and more post-treatment side-effects compared with MAL-PDT.
Original language | English |
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Pages (from-to) | 1056-1063 |
Number of pages | 8 |
Journal | British Journal of Dermatology |
Volume | 178 |
Issue number | 5 |
DOIs | |
Publication status | Published - 1 May 2018 |
Keywords
- NORMAL MOUSE SKIN
- 5-YEAR FOLLOW-UP
- LIGHT FRACTIONATION
- SIGNIFICANTLY IMPROVES
- 2-FOLD ILLUMINATION
- FLUORESCENCE
- SURGERY
- CANCER
- METAANALYSIS
- GUIDELINES