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Long‐term outcomes following foscan®‐PDT of basal cell carcinomas
Author(s) -
Betz Christian S.,
Rauschning Winrich,
Stranadko Evgueni Ph.,
Riabov Mikhail V.,
Volgin Valery N.,
Albrecht Volker,
Nifantiev Nikolay E.,
Hopper Colin
Publication year - 2012
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.22056
Subject(s) - medicine , photodynamic therapy , surgery , photosensitizer , basal cell carcinoma , population , basal cell , urology , chemistry , environmental health , organic chemistry
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. Lasers Surg. Med. 44: 533–540, 2012. © Wiley Periodicals, Inc.