A 5 year follow-up study of MAL-PDT treatment of Basal cell carcinoma and Actinic keratosis

Abstract Introduction: None melanoma skin cancer is divided into basal cell carcinoma and squamous cell carcinoma. The incidences of these tumours are increasing in the Caucasian population with increasing sun exposed leisure activities. Traditionally BCCs have been treated with excision surgery, but now several new treatment modalities have emerged. Photodynamic therapy is one of these new therapeutic options, but so far long follow-up data has been missing. Materials and Method: From 1997 until 2002 the Norwegian Radium Hospital conducted a compassionate-use study with topical MAL-PDT. The database established during that study has now been updated, which represents the basis of the actual study, with a minimum 5 year follow-up of the material. A total of 424 patients were revised, with 1857 BCC and 601 AK. Results: The overall complete response rate for BCC was found to be 79%, with decreasing cure rate, in the range of 84% to 52%, for increasing lesion thickness and infiltration grade. For AK we found the overall complete response rate to be 62%, with the results for AK thin and medium, 63% and 56%, respectively. The cosmetic outcome was considered most satisfactory, either Good or Excellent for 98% and 99% of BCC and AK, respectively, for complete responding lesions. Discussion: During the first 3 years we observed a certain amount of recurrences. Thereafter, the recurrence rate seems to flatten out. The 5 year recurrence rate after MAL-PDT seems to be acceptable compared to other treatment options, especially when we take the cosmetic outcome into consideration