| Title | [Photodynamic therapy with methylaminooxopentanoate (Metvix) and a broad band light source (PhotoDyn 501): practical experiences in problem-patients with actinic keratoses and basal cell carcinomas] | | Author(s) | Kreutzer K, Bonnekoh B, Franke I, Gollnick H | | Institution | Klinik für Dermatologie und Venerologie, Otto-von-Guericke-Universität, Magdeburg. | | Source | J Dtsch Dermatol Ges 2004 Dec; 2(12):992-9. | | MeSH | Aged
Aged, 80 and over
Aminolevulinic Acid
Carcinoma, Basal Cell
English Abstract
Female
Humans
Keratosis
Lighting
Male
Middle Aged
Photochemotherapy
Photosensitivity Disorders
Photosensitizing Agents
Skin Neoplasms
Treatment Outcome
| | Abstract | BACKGROUND: Actinic keratoses (AK) and basal cell carcinomas (BCC) may represent a therapeutic challenge because of special subtypes, location, previous therapy or accompanying diseases. Photodynamic therapy (PDT) offers a semi-conservative treatment option for selected indications.
PATIENTS AND METHODS: 28 outpatients who had been admitted as complicated dermato-oncologic cases because of AK (n = 22) and BCC (n = 6) were treated with PDT, using methylaminooxopentanoate (MAOP, Methyl-Ala, Metvix) and a broad band light source (PhotoDyn 501). The treatment was evaluated for efficacy and subjective tolerance (local discomfort and pain).
RESULTS: A complete remission (CR) was achieved in 11/22 AK (50%) and 4/6 BCC (67%) cases. All three cases of a superficial BCC subtype underwent a CR. Among responders, tolerance was good in 12/15 cases (80%), as compared to 4/13 cases (31%) in non-responders. Focusing on 16/28 patients with good tolerance (57%), there was a CR in 12 cases (75% rate), whereas for the 12/28 patients with moderate to poor tolerance a CR was achieved in only 3 cases (25% rate). In a subgroup of 8 patients who, partly due to secondary diseases, were taking systemic retinoids or immunosuppressive-cytostatic medications, a CR was achieved in 3/8 cases (38%) with a good tolerance in only 1/8 cases (13%).
CONCLUSION: These observations confirm a good efficacy and tolerance of PDT in > or = 50% of a AK/BCC problem patient cohort. We found indications for 1) a positive correlation between efficacy and subjective tolerance as well as 2) the presumptive existence of a retinoid-dependent cutaneous PDT hyperalgesia. Effective pain control seems to be an essential cofactor for the success of PDT. | | Language | ger | | Pub Type(s) | Controlled Clinical Trial
Journal Article
| | PubMed ID | 16285312 |
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