Can the carbon dioxide laser completely ablate basal cell carcinomas? A histological study

Basal Cell Carcinoma. Treatment with Carbon Dioxide Laser Vaporization

“…In With ablative lasers as carbon dioxide laser (Adams and Price 1979, Wheeland et al 1987, Fairhurst et al 1992, Grobbelaar et al 1997, Krunic et al 1998, Humpreys et al 1998, Horlock et al 2000, Nouri et al 2002, Campolmi et al 2002, Robinson et al 2003 and erbium:YAG laser (Smuckler et al 2008), the angiogenic component being a guide to the surgeon that indicates the elimination of the tumour, the lesion can be vaporized as deep as possible with the increase of the passes number. The ability to vaporize of carbon dioxide laser is higher than erbium:YAG laser and the majority of studies concerning the treatment of BCC with ablative lasers was performed with CO2 laser.…”

“…Carbon dioxide laser treatment of BCC have been largely described several years ago but few studies have been performed and they showed very different results (Adams and Price 1979, Wheeland et al 1987, Humpreys et al 1998, Horlock et al 2000, Campolmi et al 2002. Adams and Price (1979) reported the use of the carbon dioxide laser to treat BCC in 1979 using a continuous output laser.…”

“…Although hypertrophic scarring occurred in 5% of patients, the authors emphasize the advantages of laser treatment, including minimal postoperative pain, rapid healing and superior cosmetic results. Horlock et al (2000) treated 21 superficial, 28 nodular and 2 infiltrative basal cell carcinomas with multiple passes until clinical resolution was obtained and subsequently treated with two additional passes. Nodular tumours less than 10 mm diameter were completely ablated if they were vaporize to a depth of the lower dermis or deeper, whereas large nodular tumors greater than 10 mm had a high incomplete ablation rate.…”

“…Several treatment options for basal cell carcinoma have been described including surgical excision (Walker et al 2006), curettage (Barlow et al 2006) and cautery (Spiller et al 1984), cryotherapy (Mallon et al 1996, Kokoszka 2003, radiotherapy (AlOthman 2001), photodynamic therapy (Star et al 2006, Chapas et al 2006, Brathen et al 2007, micrographic surgery (Bieley et al 1992, Rowe et al 1989), ablative laser (Goldman and Wilson 1964, MacGuff 1966, Goldman et al 1968, Adams and Price 1979, Wheeland et al 1987, Fairhurst et al 1992, Grobbelaar et al 1997, Krunic et al 1998, Humpreys et al 1998, Horlock et al 2000, Nouri et al 2002, Campolmi et al 2002, Robinson et al 2003, and Smuckler et al 2008, other laser systems (El-Tonsy et al 2004, Moskalik et al 2009, Allison et al 2003, Campolmi et al 2008, Shah et al 2009, Konnikov et al 2011, Ibrahimi et al 2011, topical treatment with 5-fluorouracil and immunomodulators, such as imiquimod (Kagy andAmonette 2000, Schulze et al 2005) and intralesional agents as interferon (Greenway et al 1986).…”

Combined CO2 Laser With Photodynamic Therapy for the Treatment of Nodular Basal Cell Carcinomas

“…10 These modalities when used alone have a number of limitations when compared with surgical excision, including a limited depth of penetration of PDT (2-mm absorption), which potentially limits the efficacy of treatment of nodular BCCs greater than this thickness or which are deeply invasive. 10 In our unit, we have treated BCCs successfully with either modality to avoid surgery, albeit with higher recurrence rates than surgery, reflecting the published evidence. We describe our experience of combination therapy with both modalities in 12 patients, with the aim of improving treatment efficacy.…”