Several open studies report the efficacy of topical photodynamic therapy (PDT) in the treatment of non-melanoma skin cancer and pre-cursor lesions. For a new therapy to change clinical practice, comparison studies with standard therapies are required, assessing efficacy, adverse events and cosmetic outcome. This review considers the evidence for using topical PDT over standard therapies in non-melanoma skin cancer. Limited data indicates topical PDT to be superior to cryotherapy and equivalent to topical 5-fluorouracil in clearing non-hyperkeratotic actinic keratoses, and to achieve a superior cosmetic outcome. Topical PDT is superior to topical 5-fluorouracil, and equivalent to cryotherapy, in the treatment of squamous cell carcinoma in situ (Bowen's disease), again with fewer adverse reactions. Similarly, PDT is as effective as cryotherapy for basal cell carcinoma, but with superior healing and cosmesis. PDT may be particularly advantageous for large and/or multiple lesions and for those in sites where disfigurement or poor healing from conventional therapies is a particular risk. There remains a lack of comparison data concerning routine surgery, curettage, and radiotherapy, but topical PDT would appear as effective as, and in certain aspects superior to, standard therapies in the treatment of non-melanoma skin cancer.
Field experiments were conducted in Michigan, Minnesota, and Wisconsin in 1990 to explore interactions between nicosulfuron applied POST and terbufos insecticide at 0.06 or 0.11 g ai/m of row applied in-furrow on ‘Pioneer 3751’ field corn and ‘Jubilee’ sweet corn. Nicosulfuron at 0, 70, and 140 g ai/ha plus nonionic surfactant and 28% nitrogen fertilizer was applied to both corn types. Field corn response to nicosulfuron and terbufos was similar at all locations, whereas sweet corn injury varied with location. Nicosulfuron injured field corn more when applied at the four-leaf than the three-leaf stage. Injury to both corn types increased as nicosulfuron rate increased or when applied following terbufos. Nicosulfuron at 140 g/ha without terbufos did not reduce yield of either corn type; however, corn previously treated in-furrow with terbufos reduced yield.
Topical photodynamic therapy (PDT) is an effective treatment for certain non-melanoma skin cancers (NMSCs), including superficial and nodular basal cell carcinomas (sBCC and nBCC), actinic keratosis (AK) and Bowen's disease. Methyl aminolevulinate (MAL, Metvix) is licensed in Europe for use in PDT for sBCC, nBCC and thin or non-hyperkeratotic and non-pigmented AK on the face and scalp, where other therapies are unsuitable. Optimal PDT response can be achieved through appropriate patient selection and lesion preparation. Evidence of efficacy is reviewed from guidelines and clinical experience. Red light from an LED source offers a relatively efficient method of activating the photodynamic reaction. The most common side effect of PDT is pain, burning or stinging discomfort at the site of treatment, although most patients do not request pain relief. The incidental observation of surface fluorescence three hours after photosensitizer application can be utilized for tumour detection as well as delineation. Topical PDT using Metvix MAL offers a practical non-invasive therapy option with the potential for high efficacy and good cosmesis.
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