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- Title
Treatment of superficial basal cell carcinoma by topical photodynamic therapy with fractionated 5‐aminolaevulinic acid 20% vs. two‐stage topical methyl aminolaevulinate: results of a randomized controlled trial.
- Authors
Kessels, J. P. H. M.; Kreukels, H.; Nelemans, P. J.; Roozeboom, M. H.; van Pelt, H.; Mosterd, K.; de Haas, E. R. M.; Kelleners‐Smeets, N. W. J.
- Abstract
Summary: 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.
- Subjects
BASAL cell carcinoma treatment; PORPHOBILINOGEN synthase; PHOTODYNAMIC therapy; PHOTOTHERAPY; RANDOMIZED controlled trials
- Publication
British Journal of Dermatology, 2018, Vol 178, Issue 5, p1056
- ISSN
0007-0963
- Publication type
Article
- DOI
10.1111/bjd.15967