Topical photodynamic therapy for primary Bowen disease and basal cell carcinoma: optimizing patient selection

Hambly, Róisín; Mansoor, Nazish; Quinlan, Catherine; Shah, Z.; Lenane, Patsy; Ralph, Nicola; Moloney, Fergal J.

doi:10.1111/bjd.15281

Cited by 4 publications

(7 citation statements)

References 6 publications

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“…This is an ideal surgical method for repairing the skin defect of penile wounds. Because the lesions are located in the epidermis and rarely invade the deep part, smaller intraepithelial neoplasia lesions are often treated with radiotherapy, cryotherapy ( 6 ), laser therapy, photodynamic therapy ( 7 ), or 5-fluorouracil ointment ( 8 ). However, the recurrence rate is higher after these treatments.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Treatment of Penile Intraepithelial Neoplasia in an Asian Male With Reconstructive Plastic Surgery

et al. 2021

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Intraepithelial neoplasia is a special type of squamous cell carcinoma occurring in the skin epidermis. The incidence of penile intraepithelial neoplasia in Asian males is rare. We report the clinical characteristics and treatment process of a case of penile intraepithelial neoplasia in a Chinese man. We treated the disease of this patient by surgical excision of the penile lesion and scrotal flap plastic surgery. After surgery, the shape of the penis was satisfactory, and there was no adverse effect on erection. The pathological results confirmed the diagnosis of penile intraepithelial neoplasia. The pathological features showed that the lesion tissue was covered with squamous epithelium and that there was severe atypical hyperplasia of the lesion epithelium, disordered arrangement of polarity, and an intact basement membrane. The removal of the lesions of penile intraepithelial neoplasia through a wider surgical resection range, combined with the stretchability of a scrotal flap, can achieve a good healing effect of the surgical wound and reduce the possibility of recurrence of penile intraepithelial neoplasia.

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Section: Discussionmentioning

confidence: 99%

Case Report: Treatment of Penile Intraepithelial Neoplasia in an Asian Male With Reconstructive Plastic Surgery

et al. 2021

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“…Forty-three studies, enrolling a total of 1943 BD lesions and 282 SCC lesions between 1994 and 2019, were used for quantitative analysis. Thirty-two studies 1,2,5,6,11, used red light, whereas 9 studies 4,42-49 used laser. Twenty-four studies 3,4,6,16,21,28,[31][32][33][34][35][36][37][38][40][41][42][44][45][46][47][48][49][50] used aminolevulinic acid (ALA), and 18 studies 1,2,5,11,[15][16][17][18][19][22][23][24][25][26][27]29,30,39 used methyl aminolevulinate (MAL) as a photosensitizer (see Supplemental Digital Content 2, Table S2, http://links.lww.com/DSS/ B13).…”

Section: Study Selectionmentioning

confidence: 99%

“…Thirty-two studies 1,2,5,6,11, used red light, whereas 9 studies 4,42-49 used laser. Twenty-four studies 3,4,6,16,21,28,[31][32][33][34][35][36][37][38][40][41][42][44][45][46][47][48][49][50] used aminolevulinic acid (ALA), and 18 studies 1,2,5,11,[15][16][17][18][19][22][23][24][25][26][27]29,30,39 used methyl aminolevulinate (MAL) as a photosensitizer (see Supplemental Digital Content 2, Table S2, http://links.lww.com/DSS/ B13). Excluding studies that reported occlusion time as range (n 5 9) and mean occlusion time of 3.53 (SD 5 1.99) and 6.11 (SD 5 5.79) hours were found for BD and SCC, respectively.…”

Section: Study Selectionmentioning

confidence: 99%

“…A photosensitizing agent is applied to a lesion or field, and a light source is used to activate the agent, selectively eliminating tumor cells through a photochemical reaction. Some studies have found PDT to have an excellent efficacy and cosmesis in the treatment of BD 1,2 and cSCC. 3,4 For BD, PDT has been shown to be more effective than cryotherapy and topical 5-fluorouracil, which reported clearance rates (CRs) of 68% and 69% at 12 months, respectively.…”

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confidence: 99%

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Durable Clearance Rate of Photodynamic Therapy for Bowen Disease and Cutaneous Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

2022

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BACKGROUND Although surgery is the treatment of choice for Bowen disease (BD) and cutaneous squamous cell carcinoma (cSCC), nonsurgical treatments such as photodynamic therapy (PDT) may be preferred for select tumors. Previous meta-analysis have failed to gather strong evidence to recommend PDT. OBJECTIVE This study evaluates the effectiveness of PDT in the treatment of cSCC and BD for clearance rate (CR) after 1 year. METHODS A literature search of studies of biopsy-proven BD and cSCC treated with PDT was performed. Pooled CRs were estimated. Subgroup analyses were performed based on follow-up, treatment regimen, lesion size, and site. RESULTS Forty-three studies were included, enrolling 1943 BD lesions and 282 SCC lesions. Pooled CRs for BD and SCC were 76% (95% CI: 71%–80%; I2 = 78.9%) and 51% (95% CI: 35%–66%; I2 = 85.7%), respectively. CONCLUSION Our findings support the selective use of PDT for BD; however, patients should be advised of potential for recurrence. Although PDT can be used for certain cases of cSCC, the high rate of treatment failure necessitates close surveillance for residual or recurrent disease. Further studies are needed to justify the usage of PDT in the treatment of BD and cSCC.

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“…Surgical excision offers the advantages of margin control and confirmation of diagnosis [8], but also introduces undesirable scars. Also, when dealing with multiple or large lesions, lesions in potentially poor healing sites, for example, lower limb, which are defined based on clinicians’ anticipation of good or poor healing at a site [9, 10], or those in areas of high cosmetic importance (such as facial, digital, nail bed, and penile lesions), a relatively less invasive treatment with better cosmetic outcomes is needed.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Photodynamic Therapy for the Treatment of Bowen’s Disease: A Meta-Analysis of Randomized Controlled Trials

et al. 2021

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Background: Photodynamic therapy is an established treatment option for Bowen’s disease. Our meta-analysis was aimed at evaluating the efficacy and recurrence of photodynamic therapy or other topical treatments (5-fluorouracil, cryotherapy) and of photodynamic therapy alone or in combination with other therapies (ablative fractional CO2 laser or plum-blossom needle) for the treatment of Bowen’s disease. Methods: Trials that met our inclusion criteria were identified from PubMed, EMBASE, Web of Science, and Cochrane Library databases, and meta-analyses were conducted with RevMan V.5.4. The risk of bias was estimated with the Cochrane Collaboration’s risk of bias tools. Complete response rate, recurrence, pain/visual analogue scale score, cosmetic outcome, and adverse events were considered as outcomes. Results: Of the 2,439 records initially retrieved, 8 randomized controlled trials were included in this meta-analysis. According to our analyses, photodynamic therapy exhibited a significantly higher complete response rate (RR = 1.36, 95% CI [1.01, 1.84], I2 = 86%, p = 0.04), less recurrence (RR = 0.53, 95% CI [0.30, 0.95], I2 = 0%, p = 0.03), and better cosmetic outcome (RR = 1.34, 95% CI [1.15, 1.56], I2 = 0%, p = 0.0002) compared with other treatments. Moreover, there was a significant difference between the complete response rate of photodynamic therapy combined with ablative fractional CO2 laser and that of photodynamic therapy (RR = 1.85, 95% CI [1.38, 2.49], I2 = 0%, p < 0.0001). Photodynamic therapy combined with ablative fractional CO2 laser or plum-blossom needle also showed significantly less recurrence (RR = 0.21, 95% CI [0.09, 0.51], I2 = 0%, p = 0.0005) and a lower visual analogue scale score (RR = 0.51, 95% CI [0.06, 0.96], I2 = 0%, p = 0.03) than photodynamic therapy alone. However, there was no significant difference in the complete response rate between photodynamic therapy combined with ablative continuous CO2 laser and photodynamic therapy combined with ablative fractional CO2 laser (RR = 1.00, 95% CI [0.54, 1.86], I2 not applicable, p = 1.00). Conclusions: This meta-analysis shows that photodynamic therapy can be used in the treatment of Bowen’s disease with better efficacy, less recurrence, and better cosmetic outcomes than cryotherapy and 5-FU. Some methods, including ablative fractional CO2 laser, can be applied in combination with photodynamic therapy to improve efficacy. However, which laser-assisted photodynamic therapy scheme has the most advantages in the treatment of Bowen’s disease warrants further exploration.

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Topical photodynamic therapy for primary Bowen disease and basal cell carcinoma: optimizing patient selection

Cited by 4 publications

References 6 publications

Case Report: Treatment of Penile Intraepithelial Neoplasia in an Asian Male With Reconstructive Plastic Surgery

Case Report: Treatment of Penile Intraepithelial Neoplasia in an Asian Male With Reconstructive Plastic Surgery

Durable Clearance Rate of Photodynamic Therapy for Bowen Disease and Cutaneous Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Efficacy of Photodynamic Therapy for the Treatment of Bowen’s Disease: A Meta-Analysis of Randomized Controlled Trials

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