Photodynamic therapy versus topical imiquimod versus topical fluorouracil for treatment of superficial basal-cell carcinoma: a single blind, non-inferiority, randomised controlled trial

Arits, A.H.M.M.; Mosterd, Klara; Essers, Brigitte; Spoorenberg, E.; Sommer, A.; Rooij, M.J.M. de; Pelt, Han P. A. van; Quaedvlieg, Patricia J F; Krekels, Gertruud A. M.; Neer, P. A. F. A. van; Rijzewijk, J.J.; Geest, Adrienne J. van; Steijlen, P.M.; Nelemans, Patty J.; Kelleners‐Smeets, Nicole W.J.

doi:10.1016/s1470-2045(13)70143-8

Cited by 269 publications

(304 citation statements)

References 22 publications

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“…Various regimens of imiquimod have been used in practice, including application twice daily, once daily, and every other day; applications have been performed with and without occlusion for treatment courses ranging from 6 to 16 weeks. 45,[64][65][66][67][68][69][70][71][72][73] Overall, rates of 3-to 12-month clinical and histologic cure have been reported to range from 60% to 80% in well-designed RCTs, with the highest rates reported for shorter follow-up and clinical J AM ACAD DERMATOL VOLUME jj, NUMBER j cure. Moderate-to-severe local treatment-associated adverse events include skin redness, swelling, erosions, crusts, vesicles, itching, and, occasionally, tingling sensations.…”

Section: Topical Therapiesmentioning

confidence: 99%

“…Moderate-to-severe local treatment-associated adverse events include skin redness, swelling, erosions, crusts, vesicles, itching, and, occasionally, tingling sensations. 64 These tissue effects may vary greatly in severity from one individual to the next and may limit patient compliance. In addition, imiquimod use for larger surface areas may be associated with systemic symptoms, including fatigue, influenza-like symptoms, myalgia, and headache.…”

Section: Topical Therapiesmentioning

confidence: 99%

“…35,38,64,74,76,77,[80][81][82]86,87,99 Application of the photosensitizer is often preceded by light curettage of BCCs. 99 Usually a single treatment cycle is performed, but treatments may be repeated.…”

Section: Photodynamic Therapymentioning

confidence: 99%

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Guidelines of care for the management of basal cell carcinoma

Baum¹,

Bordeaux²,

Brown³

et al. 2018

Journal of the American Academy of Dermatology

311

219

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Basal cell carcinoma (BCC) is the most common form of human cancer, with a continually increasing annual incidence in the United States. When diagnosed early, the majority of BCCs are readily treated with office-based therapy, which is highly curative. In these evidence-based guidelines of care, we provide recommendations for the management of patients with BCC, as well as an in-depth review of the best available literature in support of these recommendations. We discuss biopsy techniques for a clinically suspicious lesion and offer recommendations for the histopathologic interpretation of BCC. In the absence of a formal staging system, the best available stratification based on risk for recurrence is reviewed. With regard to treatment, we provide recommendations on treatment modalities along a broad therapeutic spectrum, ranging from topical agents and superficially destructive modalities to surgical techniques and systemic therapy. Finally, we review the available literature and provide recommendations on prevention and the most appropriate follow-up for patients in whom BCC has been diagnosed. ( J Am Acad Dermatol

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Section: Topical Therapiesmentioning

confidence: 99%

Section: Topical Therapiesmentioning

confidence: 99%

See 1 more Smart Citation

Guidelines of care for the management of basal cell carcinoma

Baum¹,

Bordeaux²,

Brown³

et al. 2018

Journal of the American Academy of Dermatology

311

219

View full text Add to dashboard Cite

show abstract

“…This again argues for the advantage of using combination therapies with PDT, namely adding on imiquimod after treatment. 81 A consensus group in Canada and Europe analyzed nine studies and report that use of MAL-PDT can be considered as a safe and effective treatment for BCC in patients with Gorlin syndrome, the efficacy being proportionate to the thickness of the lesion. 82 PDT has been observed to have chemopreventive effects in patients with Gorlin syndrome.…”

Section: Mal-pdt In Treatment Of Bccmentioning

confidence: 99%

Current Evidence and Applications of Photodynamic Therapy in Dermatology

2015

Journal of the Dermatology Nurses' Association

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Abstract:In photodynamic therapy (PDT) a photosensitizer -a molecule that is activated by light -is administered and exposed to a light source. This leads both to destruction of cells targeted by the particular type of photosensitizer, and immunomodulation. Given the ease with which photosensitizers and light can be delivered to the skin, it should come as no surprise that PDT is an increasingly utilized therapeutic in dermatology. PDT is used commonly to treat precancerous cells, sun-damaged skin, and acne. It has reportedly also been used to treat other conditions including inflammatory disorders and cutaneous infections. This review discusses the principles behind how PDT is used in dermatology, as well as evidence for current applications of PDT.

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“…Most BCCs are solitary 1 and, in respect of size, histologic subtype, number and patient characteristics, can be treated with surgery, cryo-, photodynamic or radiotherapy, or using 83.4% (95% CI 74.7-85.9) of imiquimod patients were tumor-free 2 . At three year follow up, the results dropped to 58% (95% CI 47.8 -66.9) in MAL-PDT, to 68.2% of fluoruracil (95% CI 58.1-76.3) and remained stable in imiquimod group, with 79.7% (95% CI 71.6-85.7) of patients remaining tumor-free 3 .…”

Section: Introductionmentioning

confidence: 99%