Effectiveness of photodynamic therapy in Bowen’s disease: an observational and descriptive study in 51 lesions

Truchuelo, M.; Fernández‐Guarino, M.; Fleta, B.; Alcántara, Javier; Jaén, Pedro

doi:10.1111/j.1468-3083.2011.04175.x

Cited by 53 publications

(69 citation statements)

References 36 publications

(76 reference statements)

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“…68 Complete clinical clearance rates of 88-100% are reported 3 months after one cycle of MAL-PDT, with 68-89% of treated lesions remaining clear over follow-up periods of 17-50 months. 40,[70][71][72][73] A multicentre, randomized study compared MAL-PDT with cryotherapy or 5-FU in 225 patients with 275 SCCs in situ.…”

Section: Photodynamic Therapy (Strength Of Recommendation A; Level Ofmentioning

confidence: 99%

BritishAssociation ofDermatologists' guidelines for the management of squamous cell carcinomain situ(Bowen's disease) 2014

et al. 2014

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Section: Photodynamic Therapy (Strength Of Recommendation A; Level Ofmentioning

confidence: 99%

BritishAssociation ofDermatologists' guidelines for the management of squamous cell carcinomain situ(Bowen's disease) 2014

et al. 2014

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“…The light energy absorbed by the photoactive porphyrin is transferred to oxygen, generating ROS. Two MAL PDT sessions 8 days apart are recommended for the treatment of BD.The effectiveness (complete clearance) of PDT for the treatment of BD is approximately 80%, with recurrences in 10-20% of cases (8,11,13). Side-effects are essentially local erythema, oedema, warmth, burning, tingling and painful sensations (13,14).…”

mentioning

confidence: 99%

Squamous Cell Carcinoma Following Photodynamic Therapy for Cutaneous Bowen’s Disease in a Series of 105 Patients

Ratour-Bigot

Chemidling²,

Montlahuc³

et al. 2016

Acta Derm Venerol

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Bowen's disease (BD) is an intra-epidermal carcinoma of the skin, which, if untreated, may progress to invasive squamous cell carcinoma (SCC) in 3-5% of cases (1). BD can occur anywhere on the skin in adults, especially in elderly people. BD usually presents as an asymptomatic circular erythematous scaly patch localized on a sunexposed area. Typically, BD has an excellent prognosis because of its slow evolution and good response to treatment. Although surgery is often the best treatment option for BD, new therapies have emerged in recent years. Alternatives to surgery, such as photodynamic therapy (PDT), cryosurgery, 5-fluorouracil and imiquimod, have been proposed for BD, especially when it is located in sensitive surgical areas (face, fingers, etc.) (1-11). PDT is also used in the treatment of actinic keratoses (AK) and superficial basal cell carcinomas. Its use in other fields of dermatology is under evaluation (12).PDT is based on the application of a photosensitizing product or its precursor, which is activated by a light source of an appropriate wavelength according to the absorption spectrum of the photosensitizer and offers sufficient penetration. Its activation causes the selective destruction of malignant cells via production of reactive oxygen species (ROS). Methyl aminolevulinate (MAL) in its hydrochloride form is a photosensitizing product for cutaneous application, marketed under the name of Metvixia ® . Irradiation is performed using a light source with a wavelength between 570 and 670 nm within the absorption spectrum of porphyrins. PDT using Metvixia ® is abbreviated MAL PDT. The light energy absorbed by the photoactive porphyrin is transferred to oxygen, generating ROS. Two MAL PDT sessions 8 days apart are recommended for the treatment of BD.The effectiveness (complete clearance) of PDT for the treatment of BD is approximately 80%, with recurrences in 10-20% of cases (8,11,13). Side-effects are essentially local erythema, oedema, warmth, burning, tingling and painful sensations (13,14).PDT is considered to be a safe treatment, although its carcinogenic risk has never been studied. However, several cases of SCC after PDT have been reported in the literature (15, 16). We studied the occurrence of SCC following PDT treatment in a series of 105 patients with BD. METHODSA monocentric retrospective study of patients with cutaneous BD treated by PDT between 2007 and 2013 was conducted in the Department of Dermatology at Saint Louis Hospital, Paris, France. Data studied were the patients' age, sex, history of SCC, immunosuppression, location of BD treated by PDT, number of treated lesions, number of PDT sessions performed, response to PDT at 3 months, and occurrence of SCC on a PDT field or outside a PDT field. The fields treated with PDT were classified into 4 regions: head and neck, trunk, upper limbs and lower limbs. The efficacy of PDT on BD 3 months after therapy was qualified as complete response (CR) when complete regression of the lesion occurred, partial response (PR) when part of the BD lesi...

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“…MAL-PDT was effective in treating lesions over 3 cm, with clearance rates of 96% in 3 months after one cycle of two treatments, with only three recurrences in a follow-up of 1 year [101]. Comparable outcomes have been reported form an observational study of 51 BD lesions which had been treated with two MAL-PDT treatments one week apart leading to clearance rates of 76.09% at 16.61 months with excellent cosmetic outcome and only mild cutaneous adverse effects [102].…”

Section: Squamous Cell Carcinomamentioning

confidence: 81%

Photodynamic Therapy and Skin Cancer

Papakonstantinou¹,

Löhr²,

Raap³

2018

Dermatologic Surgery and Procedures

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Non-melanoma skin cancer (NMSC) is the most common type of cancer among white skin individuals worldwide with an increasing incidence over the last years. NMSC is mostly treated with surgical or non-invasive methods such as cryotherapy or topical chemotherapeutics. Over the last years, there has been a rapidly growing interest in the use of photodynamic therapy (PDT) which is a well-tolerated, safe and effective alternative treatment option. PDT involves a photosensitizer, a light source and tissue oxygen and is based on a photo-oxidation reaction in the target tissue which results to a selective destruction of the cancer cells. PDT has been approved for treatment of actinic keratosis, Bowen's disease and basal cell carcinoma in Europe. Off-label uses include treatment of invasive squamous cell carcinoma, cutaneous T-cell lymphoma, Kaposi's sarcoma, Paget's disease and prevention of recurrence of squamous cell carcinoma in organ-transplant recipients. Also combination of PDT with other treatment options such as cryotherapy, surgery and topical therapies has been reported with improved efficacy, tolerability and long-term results. Development of novel photosensitizers and light sources together with targeted delivery systems will increase specificity, efficiency and treatment field of PDT in the future. This chapter aims to give the reader an overview of the important applications of PDT, including indications, approved treatments, advantages and disadvantages of this method such as future trends.

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Effectiveness of photodynamic therapy in Bowen’s disease: an observational and descriptive study in 51 lesions

Abstract: Photodynamic therapy is an effective treatment for BD in terms of both clinical remission and cosmetic results, with good tolerance and minimal adverse effects.

Cited by 53 publications

References 36 publications

BritishAssociation ofDermatologists' guidelines for the management of squamous cell carcinomain situ(Bowen's disease) 2014

BritishAssociation ofDermatologists' guidelines for the management of squamous cell carcinomain situ(Bowen's disease) 2014

Squamous Cell Carcinoma Following Photodynamic Therapy for Cutaneous Bowen’s Disease in a Series of 105 Patients

Photodynamic Therapy and Skin Cancer

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