Optimized Photodynamic Therapy with Systemic Photosensitizer Following Debulking Technique for Nonmelanoma Skin Cancers
Article first published online: 2 FEB 2007
Volume 33, Issue 2, pages 194–198, February 2007
How to Cite
SOUZA, C. S., NEVES, A. B. S., FELÍCIO, L. A. B., FERREIRA, J., KURACHI, C. and BAGNATO, V. S. (2007), Optimized Photodynamic Therapy with Systemic Photosensitizer Following Debulking Technique for Nonmelanoma Skin Cancers. Dermatologic Surgery, 33: 194–198. doi: 10.1111/j.1524-4725.2006.33038.x
- Issue published online: 2 FEB 2007
- Article first published online: 2 FEB 2007
Vol. 33, Issue 4, 523, Article first published online: 6 APR 2007
BACKGROUND The thickness and depth of invasion of skin tumors may be limiting factors for topical photosensitizer-based photodynamic therapy (PDT). The use of PDT with systemic photosensitizer needs to be further explored as a modality of treatment for nonmelanoma skin cancer (NMSC).
OBJECTIVE The objective was to present six patients with multiple, nodular, and/or pigmented NMSC treated successfully with purified hematoporphyrin derivative (PHD) and PDT using prior debulking.
METHODS After 24 hours of systemic PHD (1.5 mg/kg), 12 lesions of NMSC were selected for PHD-PDT alone and 6 nodular/elevated lesions for PHD-PDT following a debulking procedure. The tumor area was illuminated in one single-dose session of 300 J/cm2, at an intensity range of 130 to 150 mW/cm2, with a 630-nm-wavelength diode laser.
RESULTS The prior curettage provided significant reduction in volume and/or pigmentation of lesions. After the session of PHD-PDT with prior curettage and additional topical 20% ALA-PDT in two lesions or PHD-PDT alone, 83% (5/6) of lesions and 58% (7/12) of lesions, respectively, maintained a complete clinical response, 22.2±8.9 months of follow-up.
CONCLUSIONS The combination of prior debulking with systemic agents-PDT appears to be a good option for multiple, pigmented, and/or nodular lesions of NMSC and can allow the improvement of clinical results.