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| PHOTODYNAMIC THERAPY OF NONMELANOMA MALIGNANT-TUMORS OF THE SKIN USING TOPICAL DELTA-AMINO LEVULINIC ACID SENSITIZATION AND LASER IRRADIATION |
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| Author(s): SVANBERG K, ANDERSSON T, KILLANDER D, WANG I, STENRAM U, ANDERSSONENGELS S, BERG R, JOHANSSON J, SVANBERG S |
| Source: BRITISH JOURNAL OF DERMATOLOGY Volume: 130 Issue: 6 Pages: 743-751 Published: JUN 1994 |
| Times Cited: 273 References: 15 |
| Abstract: Eighty basal cell carcinomas (BCCs) in 21 patients, 10 lesions of Bowen's disease in three patients, and four lesions of cutaneous T-cell lymphoma in two patients, were treated with photodynamic laser therapy (PDT), using topical application of the haem precursor delta-amino levulinic acid (ALA). The diagnoses were confirmed histologically prior to treatment. Fifty-five of the BCCs were superficial lesions, and 25 were nodular. Of the 80 BCCs, 39 (49%) were located on the trunk, 36 (45%) on the head and neck region, four (15%) on the leg and one on the arm. The two principal locations of the 10 Bowen's disease lesions were the leg (50%) and the trunk (40%). The T-cell lymphoma lesions were located on the shoulder and on the arm. A water-in-oil based cream containing 20% ALA was applied to the lesions, with a margin of about 10-20 mm beyond the visible tumour border, 4-6 h before the laser procedure. During this period of time the highly fluorescent and photodynamically active substance protoporphyrin IX (Pp IX) is synthesized via the haem cycle. Laser-induced fluorescence (LIF) was used for real-time monitoring of the Pp IX distribution in the tumour and in the normal surrounding skin, before and after treatment in all patients. Before laser treatment the Pp-IX distribution demonstrated by LIF showed a demarcation between tumour and normal skin of about 15:1 for BCC and Bowen's disease, and 5:1 for T-cell lymphomas. Laser light from a pulsed frequency-doubled Nd:YAG laser pumping a dye laser with light emission at 630 nn was used for the therapy. The power density in the irradiation was kept below 110 mW/cm(2), in order to avoid hyperthermal effects. A total energy of 60 J/cm(2) was delivered for 10-20 min, depending on the tumour size. A complete response rate of 100% in superficial BCCs and 64% in nodular BCCs occurred after a single laser treatment, and a response rate of 100% was achieved after one additional. treatment in the nodular BCCs. in the Bowen's disease lesions a complete response of 90% was obtained with a single treatment. Two of the four T-cell lymphomas resolved completely. The follow-up time was between 6 and 14 months. |
| Document Type: Article |
| Language: English |
| Reprint Address: SVANBERG, K (reprint author), UNIV LUND HOSP, DEPT ONCOL, S-22185 LUND, SWEDEN |
Addresses:
1. UNIV LUND HOSP, DEPT PATHOL, S-22185 LUND, SWEDEN
2. LUND INST TECHNOL, DIV ATOM PHYS, S-22100 LUND, SWEDEN |
| Publisher: BLACKWELL SCIENCE LTD, OSNEY MEAD, OXFORD, OXON, ENGLAND OX2 0EL |
| Subject Category: Dermatology |
| IDS Number: NQ818 |
| ISSN: 0007-0963 |
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