Topical photodynamic treatment in basal cell carcinoma [Bazal hucreli karsinomda topikal fotodinamik tedavi]

Background and Design: Basal cell carcinoma is the most common malign tumour on the skin. Photodynamic treatment is a novel method for the treatment of a variety of solid tumours. It has also been used for treatment of basal cell carcinoma. The purpose of this study was to determine the effectiveness of photodynamic treatment in the treatment of basal cell carcinoma. Material and methods: A total of 26 patients with 30 lesions (13 at the face, 8 on the nose, 4 on the scalp and finally 5 on the body) of basal cell carcinoma were included in this study. Clinically, of all the lesions, 14 lesions were superficial and 16 lesions had nodular pattern. Patients were administered topical 5-amino levulinic acid cream as photosensitizer agent. Six to eight hours after topical administration of 5- ALA, visible light irradiation was conducted with an incoherent light source. The combined red + infrared band was used during irradiation (respectively, 580-720 nm; 1250-1600 nm in wave length). Each lesion received a total dose of 100 J/cm2 at fluence rates of 100 to 120 mW/cm2. Histological and clinical evaluation were performed both before treatment and two months after treatment. Posttreatment examination were only clinically for three lesions, because second biopsy was unsuitable. In addition, each of the patients was examined clinically at two months interval. The average clinical follow-up was 6 months. Results: In clinical evaluation; complete response was achieved in 56.6% of lesions. Histologically, 62.9% of the specimens showed complete improvement rate. Clinically superficial BCC tumors were very responsive to PDT and the 14 superficial lesions treated showed a 92.8% complete response rate both clinically and histologically. 25% complete response was achieved in patients with nodular BCC lesions. The most significant side effects after treatment were moderate pain, redness and edema. The most common adverse effect during treatment was tolerable heat, itching and pain sensation. Conclusions: We can conclude that topical photodynamic therapy with ALA cream is a safe and effective modality in the treatment of superficial BCC