Pulsed dye laser treatment of superficial basal cell carcinoma: realistic or not?

Allison, Kyle; Kiernan, Michael; Waters, Ruth; Clement, R. M.

doi:10.1007/s10103-003-0261-y

Cited by 33 publications

(33 citation statements)

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“…Allison et al [10] used a single treatment of 585 nm PDL on seven BCCs, which resulted in histologic clearance of only one tumor. In superficial BCCs, using five treatments with 595 nm PDL, Campolmi et al [11,12] demonstrated in two separate studies that 16 of 20 tumors showed no clinical recurrences at a minimum follow-up of 1 year.…”

Section: Introductionmentioning

confidence: 99%

The effect of 595 nm pulsed dye laser on superficial and nodular basal cell carcinomas

Shah

Konnikov²,

Duncan

et al. 2009

Lasers Surg Med

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Background and Objective: Basal cell carcinomas (BCCs) have supporting vasculature that could serve as a target for 595 nm pulsed dye laser (PDL). The objective of this study was to determine the effect of repeated PDL treatments on BCCs of superficial and nodular subtypes and of varying diameters. Study Design/Materials and Methods: Twenty biopsyproven BCCs received four 595 nm PDL treatments at 2-week intervals. The tumor and 4 mm of peripheral skin were treated using a set of previously optimized laser parameters: one pass, 15 J/cm 2 energy, 3 ms pulse length, no cooling, and 7 mm spot size with 10% overlap. The treated area was excised and evaluated histologically for residual tumor. Histologic response rates of the PDL treated BCCs were compared with that of non-PDL treated, matched control tumors. Results: Nearly all BCCs <1.5 cm in diameter (n ¼ 12) showed complete response to four PDL treatments (91.7%; n ¼ 11/12) versus 16.7% of controls (n ¼ 2/12, P-value ¼ 0.0003). BCCs !1.5 cm in diameter (n ¼ 8) showed a complete response rate of 25% (n ¼ 2/8) versus 0% of controls (n ¼ 0/8, P-value ¼ 0.2). Mean clinical tumor diameter of the complete responders was 1.1 cm (n ¼ 13) versus 2.2 cm (n ¼ 7) for incomplete responders (P-value ¼ 0.005). Tumor histologic types among the complete responders included superficial, nodular, micronodular, and keratinizing. Incompletely responding BCCs showed a significant reduction in tumor burden after PDL treatment, with residual histologic tumor burden ranging from <1% to 29% of the original clinical tumor diameter, compared to 13-68% residual tumor burden for the corresponding controls (P-value ¼ 0.05). Conclusions: PDL is an effective means of reducing tumor burden in patients with large BCCs and may be an alternative therapy in BCCs <1.5 cm in diameter.

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Section: Introductionmentioning

confidence: 99%

The effect of 595 nm pulsed dye laser on superficial and nodular basal cell carcinomas

Shah

Konnikov²,

Duncan

et al. 2009

Lasers Surg Med

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“…MMC and 5FU are moderately and weakly bound, respectively, to albumin, the predominant plasma protein. Albumin is large enough that it has very low capillary permeability, 34 so MMC bound to albumin must clear the tissue by diffusion through the dermis. The dermal diffusion rate for MMC bound to albumin would be much lower than free MMC, due to its combined molecular size.…”

Section: Prototypmentioning

confidence: 99%

“…33 Concomitant injury to tumor vascular supply and exposure to drug at levels that are toxic to tumor cells may be a highly advantageous treatment modality. Furthermore, for treatment with MMC, and other bioreductive drugs, 34 another significant aspect of the proposed treatment method is the increase in drug cytotoxicity under the hypoxic conditions produced by the photothermal vascular injury. Treating a skin tumor with a vascular targeting laser followed by application of a drug until a steady state distribution is reached in the dermis may increase the thickness of tumors that can be treated, reduce the number of treatment sessions, or both.…”

Section: Prototypmentioning

confidence: 99%

Dual-effect laser handpiece for modification of tissue permeability

McMillan¹

2011

SPIE Proceedings

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A new approach for improving the availability of topically applied drugs by reducing the permeability of dermis has been evaluated. The premise of this work is that photothermal vascular injury will reduce vascular uptake of drug in the dermis. The dermal distribution of two topically applied drugs, 5-fluorouracil and mitomycin C, is calculated, considering molecular diffusion and vascular uptake according to a distributed model, in the presence and absence of vascular injury. Intradermal drug exposures obtained are compared to exposures known to be effective in killing tumor cells. Combining the reduction in dermal permeability with fractional photothermal epidermal ablation to increase epidermal permeability may allow higher drug concentrations to be achieved in the skin. A newly developed laser handpiece for implementing the technique is described.

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“…Seven small studies were identified from the literature review that have reported results on the treatment of BCCs with vasculature targeting PDL devices working at 585 nm [13,14] or 595 nm [15][16][17][18][19][20] (Table 1). Data from a total of 120 BCC treatments with monomodal PDL (68 trunk or extremities and 52 face tumors) with four different PDL devices are available ( Table 1).…”

Section: Review Of the Use Of Monomodal Pdl For Bccmentioning

confidence: 99%

Treatment of basal cell carcinoma using a combination of pulsed dye laser and imiquimod – Case report and review

Gaitanis

Ikiades

Bassukas

2014

Photonics &Amp; Lasers in Medicine

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Objective: To evaluate the feasibility and efficacy of a pulsed dye laser (PDL) during a 5-week course of 5% topical imiquimod application in a patient with a nodular basal cell carcinoma (BCC) and to review the literature for data on PDL treatment of BCC. Methods: A 74-year-old patient with a 7-mm biopsy-proven BCC on his nose was treated with topical daily imiquimod for 2 weeks. Subsequently a laser session was performed with a flash lamp-pumped dye laser at 595 nm (Dermobeam 2000; Deka M.E.L.A., Florence, Italy) employing one pass with the following parameters: fluence 15 J/cm 2 , 3-ms pulses, spot diameter 5 mm with 10% overlap. PubMed was searched using the term conjunctions ["basal cell carcinoma" AND "pulsed dye laser"], ["basal cell carcinoma" AND "laser therapy"] and ["skin cancer" AND "pulsed dye laser"]. Frequency counts and percentages were employed to summarize identified BCC cases treated with PDL along different studies and Fisher's exact test was used for the comparison of frequency distributions. Results: Topical imiquimod was continued for a further 3 weeks after the PDL session with a minimal increase in irritation. The tumor cleared and there has been no recurrence for 12 months. The literature search revealed a total of 7 small studies that included 120 tumors, the majority treated with a 595-nm device (104/120). Overall 81/120 (67.5%) treated tumors have been assessed as complete responders. No differences were recorded in relapse rates in association with the localization of the tumor, the histology (superficial vs. non-superficial), the wavelength of the device employed (595 vs. 585 nm), or the application of dynamic cooling. From the treatment parameters, only the use of multiple vs. single PDL sessions affected the outcome favorably (p = 0.0432; Fisher's exact test). From the BCC parameters, tumor size was a negative predictor of response. Conclusion:The combination of PDL with imiquimod could be a promising approach for the treatment of BCC and should be further evaluated in future studies.Ziel: Evaluierung der Anwendbarkeit und Wirksamkeit eines gepulsten Farbstofflasers (pulsed dye laser, PDL) zur Behandlung eines Patienten mit nodulärem Basaliom innerhalb eines 5-wöchigen Behandlungszyklus mit Imiquimod 5% und Auswertung der Literatur zum Thema PDL-Behandlung von Basalzellkarzinomen (basal cell carcinoma, BCC). Methoden: Ein 74-jähriger Patient mit einem 7-mm großen, durch Biopsie nachgewiesenen BCC auf der Nase wurde täglich über einen Zeitraum von 2 Wochen topisch mit Imiquimod behandelt. Anschließend wurde eine Laserbehandlung mit einem 595 nm-PDL (Dermobeam 2000; Deka MELA, Florenz, Italien) unter Verwendung folgender Parameter durchgeführt: Energiedichte 15 J/cm 2 , 3 ms-Pulse, Spotdurchmesser 5 mm mit 10% Überlappung. Eine PubMed-Literaturrecherche zu folgenden Suchbegriffkombinationen wurde durchgeführt: ["Basaliom" UND "gepulster Farbstofflaser"], ["Basaliom" UND "Lasertherapie"] und ["Hautkrebs" UND "gepulster Farbstofflaser"]. Häufigkeiten und Prozentsätze wurden herangezog...

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Pulsed dye laser treatment of superficial basal cell carcinoma: realistic or not?

Cited by 33 publications

References 0 publications

The effect of 595 nm pulsed dye laser on superficial and nodular basal cell carcinomas

The effect of 595 nm pulsed dye laser on superficial and nodular basal cell carcinomas

Dual-effect laser handpiece for modification of tissue permeability

Treatment of basal cell carcinoma using a combination of pulsed dye laser and imiquimod – Case report and review

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