Is the pain of topical photodynamic therapy with methyl aminolevulinate any different from that with 5‐aminolaevulinic acid?

Ibbotson, S.H.; Valentine, R.; Hearn, R.M. Ross

doi:10.1111/j.1600-0781.2012.00684.x

Cited by 10 publications

(7 citation statements)

References 5 publications

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“…PDT has been widely used to treat preneoplastic and neoplastic skin lesions due to its minimal invasiveness that allows easy access to both extensive lesions and those in difficult locations, offering optimal cosmetic outcomes [12,13]. However, in the case of NMSC, the complete response rates of PDT varies between 37% and 100%, which could be explained by the type of lesion and follow-up time reported in each clinical trial [14][15][16][17][18][19]. Unfortunately, recurrence rates show an increase 6 or 12 months after PDT [14,16,18,20].…”

Section: Introductionmentioning

confidence: 99%

Epigallocatechin Gallate Enhances MAL-PDT Cytotoxic Effect on PDT-Resistant Skin Cancer Squamous Cells

León

Buchegger

Silva

et al. 2020

IJMS

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Photodynamic therapy (PDT) has been used to treat certain types of non-melanoma skin cancer with promising results. However, some skin lesions have not fully responded to this treatment, suggesting a potential PDT-resistant phenotype. Therefore, novel therapeutic alternatives must be identified that improve PDT in resistant skin cancer. In this study, we analyzed the cell viability, intracellular protoporphyrin IX (PpIX) content and subcellular localization, proliferation profile, cell death, reactive oxygen species (ROS) detection and relative gene expression in PDT-resistant HSC-1 cells. PDT-resistant HSC-1 cells show a low quantity of protoporphyrin IX and low levels of ROS, and thus a low rate of death cell. Furthermore, the resistant phenotype showed a downregulation of HSPB1, SLC15A2, FECH, SOD2 and an upregulation of HMBS and BIRC5 genes. On the other hand, epigallocatechin gallate catechin enhanced the MAL-PDT effect, increasing levels of protoporphyrin IX and ROS, and killing 100% of resistant cells. The resistant MAL-PDT model of skin cancer squamous cells (HSC-1) is a reliable and useful tool to understand PDT cytotoxicity and cellular response. These resistant cells were successfully sensitized with epigallocatechin gallate catechin. The in vitro epigallocatechin gallate catechin effect as an enhancer of MAL-PDT in resistant cells is promising in the treatment of difficult skin cancer lesions.

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Section: Introductionmentioning

confidence: 99%

Epigallocatechin Gallate Enhances MAL-PDT Cytotoxic Effect on PDT-Resistant Skin Cancer Squamous Cells

León

Buchegger

Silva

et al. 2020

IJMS

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“…The pain levels of MAL-PDT have been variously described 4 as less severe 5;6;18 than or equal 7;8 to ALA-PDT. The experience from this and our earlier studies 12 indicates comparable irradiance-dependent pain thresholds that lie between 40 and 50 mW/cm 2 for ALA and MAL-PDT.…”

Section: Discussionmentioning

confidence: 99%

“…While achieving high durable response rates and excellent cosmetic outcomes, the pain experienced during light delivery can be a significant limiting factor of this therapy 4-8 . Various pain-relieving approaches have been used with limited success 9;10 .…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study of Pain Control by a 2-Step Irradiance Schedule During Topical Photodynamic Therapy of Nonmelanoma Skin Cancer

Zeitouni

Sunar²,

Rohrbach³

et al. 2014

Dermatologic Surgery

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Background Topical photodynamic therapy (PDT) for selected non-melanoma skin cancer, employing 5-aminolevulinic acid (ALA) or methyl aminolevulinate (MAL) has yielded high long-term complete response rates with very good cosmesis. Pain during light activation of the photosensitizer can be a serious adverse event. A two-step irradiance protocol has previously been shown to minimize ALA-PDT pain. Objectives To determine the irradiance-dependent pain threshold for MAL-PDT, to adapt the two-step protocol to an LED light source, and assess clinical response. Methods In this prospective study, 25 superficial basal cell carcinoma (sBCC) received an initial irradiance by laser at 40 or 50 mW/cm2, or LED at 35 mW/cm2 followed by an irradiance at 70 mW/cm2 for a total of 75 J/cm2. Pain levels were recorded for both irradiance steps. Efficacy was assessed at 6, 12 or 24 months. Results Pain was mild in the 40/70 mW/cm2 laser cohort. Three instances of irradiance-limiting pain occurred at 50/70 mW/cm2. Pain was minimal in the 35/70 mW/cm2 LED cohort. Clinical response rates were 80% in the 50/70 mW/cm2 laser cohort and 90% in the 35/70 mW/cm2 LED cohort. Conclusions Topical PDT can be effectively delivered to sBCC with minimal treatment related pain by a two-step irradiance protocol.

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“…However, this does not usually prevent successful delivery of the treatment, although, in some cases, it may require the treatment to be paused and/or local anesthesia to be used [4,8]. Although pain levels have been reported to differ between the use of ALA and MAL, with less pain in MAL-PDT, a cohort study found no significant difference [123]. Optimizing the topical PDT treatment of BCC is fraught by the need to balance detriments; for example, the use of cold-air analgesia, while widely used and advocated [124], may compromise clearance [8,125].…”

Section: Outcomes Of Topical Pdt Treatment Of Bccmentioning

confidence: 99%

Photodynamic Therapy for Basal Cell Carcinoma: The Clinical Context for Future Research Priorities

Collier

Rhodes

2020

Molecules

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Photodynamic therapy (PDT) is an established treatment option for low-risk basal cell carcinoma (BCC). BCC is the most common human cancer and also a convenient cancer in which to study PDT treatment. This review clarifies challenges to researchers evident from the clinical use of PDT in BCC treatment. It outlines the context of PDT and how PDT treatments for BCC have been developed hitherto. The sections examine the development of systemic and subsequently topical photosensitizers, light delivery regimens, and the use of PDT in different patient populations and subtypes of BCC. The outcomes of topical PDT are discussed in comparison with alternative treatments, and topical PDT applications in combination and adjuvant therapy are considered. The intention is to summarize the clinical relevance and expose areas of research need in the BCC context, ultimately to facilitate improvements in PDT treatment.

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Is the pain of topical photodynamic therapy with methyl aminolevulinate any different from that with 5‐aminolaevulinic acid?

Cited by 10 publications

References 5 publications

Epigallocatechin Gallate Enhances MAL-PDT Cytotoxic Effect on PDT-Resistant Skin Cancer Squamous Cells

Epigallocatechin Gallate Enhances MAL-PDT Cytotoxic Effect on PDT-Resistant Skin Cancer Squamous Cells

A Prospective Study of Pain Control by a 2-Step Irradiance Schedule During Topical Photodynamic Therapy of Nonmelanoma Skin Cancer

Photodynamic Therapy for Basal Cell Carcinoma: The Clinical Context for Future Research Priorities

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