Long-term outcomes following Foscan®-PDT of basal cell carcinomas

TY - JOUR

T1 - Long-term outcomes following Foscan®-PDT of basal cell carcinomas

AU - Betz, Christian S

AU - Rauschning, Winrich

AU - Stranadko, Evgueni Ph

AU - Riabov, Mikhail V

AU - Volgin, Valery N

AU - Albrecht, Volker

AU - Nifantiev, Nikolay E

AU - Hopper, Colin

N1 - Copyright © 2012 Wiley Periodicals, Inc.

PY - 2012/9

Y1 - 2012/9

N2 - BACKGROUND AND OBJECTIVE: In a previous publication we showed that mTHPC-PDT (Foscan®-PDT) is an effective treatment of basal cell carcinomas (BCCs) in "difficult to treat" locations and presented optimized treatment parameters to reduce costs and side effects. Now we present long-term results of the same study population.STUDY DESIGN/MATERIALS AND METHODS: Following PDT of a total of 460 BCCs in 117 subjects, the patients/lesions were followed-up for a mean duration of 42 (range: 2-72) months. Two patients dropped out of follow-up; 13 patients died of unrelated causes. Recurrences were treated either by repeated PDT or other established methods.RESULTS: The sustained clearance rate was 93.7% and the overall treatment success rate was 90.7%. Kaplan-Meier analysis revealed an estimated recurrence free fraction of patients at 5 years of 95.1%, 92.4%, 85.1%, and 74.0% for the four different photosensitizer dose groups (0.06-0.15, 0.05, 0.04, and 0.03 mg/kg). High-risk lesions (recurrences, thickness >3 mm) recurred more often than low-risk ones, and recurrences mostly (>50%) occurred during the first year of follow-up.CONCLUSION: Long-term outcomes of high-dose (0.06-0.15 mg/kg) and reduced-dose (0.05 mg/kg) Foscan®-PDT in "difficult to treat" BCCs compare favorably with other methods, even in high-risk lesions (recurrent and/or thick lesions). A recommended combination of treatment parameters for low-dose therapy seems to be: 0.05 mg/kg Foscan®, 24 hours drug-light interval (DLI), fluence ≥40 J/cm(2) . Prospective randomized studies are needed to look into low-dose mTHPC-PDT of BCCs in more detail and to directly compare it with other treatments.

AB - BACKGROUND AND OBJECTIVE: In a previous publication we showed that mTHPC-PDT (Foscan®-PDT) is an effective treatment of basal cell carcinomas (BCCs) in "difficult to treat" locations and presented optimized treatment parameters to reduce costs and side effects. Now we present long-term results of the same study population.STUDY DESIGN/MATERIALS AND METHODS: Following PDT of a total of 460 BCCs in 117 subjects, the patients/lesions were followed-up for a mean duration of 42 (range: 2-72) months. Two patients dropped out of follow-up; 13 patients died of unrelated causes. Recurrences were treated either by repeated PDT or other established methods.RESULTS: The sustained clearance rate was 93.7% and the overall treatment success rate was 90.7%. Kaplan-Meier analysis revealed an estimated recurrence free fraction of patients at 5 years of 95.1%, 92.4%, 85.1%, and 74.0% for the four different photosensitizer dose groups (0.06-0.15, 0.05, 0.04, and 0.03 mg/kg). High-risk lesions (recurrences, thickness >3 mm) recurred more often than low-risk ones, and recurrences mostly (>50%) occurred during the first year of follow-up.CONCLUSION: Long-term outcomes of high-dose (0.06-0.15 mg/kg) and reduced-dose (0.05 mg/kg) Foscan®-PDT in "difficult to treat" BCCs compare favorably with other methods, even in high-risk lesions (recurrent and/or thick lesions). A recommended combination of treatment parameters for low-dose therapy seems to be: 0.05 mg/kg Foscan®, 24 hours drug-light interval (DLI), fluence ≥40 J/cm(2) . Prospective randomized studies are needed to look into low-dose mTHPC-PDT of BCCs in more detail and to directly compare it with other treatments.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Carcinoma, Basal Cell

KW - Drug Administration Schedule

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Kaplan-Meier Estimate

KW - Lasers, Semiconductor

KW - Male

KW - Mesoporphyrins

KW - Middle Aged

KW - Neoplasm Recurrence, Local

KW - Photochemotherapy

KW - Photosensitizing Agents

KW - Skin Neoplasms

KW - Treatment Outcome

KW - Evaluation Studies

KW - Journal Article

U2 - 10.1002/lsm.22056

DO - 10.1002/lsm.22056

M3 - SCORING: Journal article

C2 - 22851213

VL - 44

SP - 533

EP - 540

JO - LASER SURG MED

JF - LASER SURG MED

SN - 0196-8092

IS - 7

ER -