氨基酮戊酸光动力疗法治疗基底细胞癌74例

目的:探讨不同方式联合氨基酮戊酸光动力疗法(ALA-PDT)治疗基底细胞癌(BCC)的疗效.方法:74例经病理确诊为浅表型或结节型BCC患者,分别采用手术联合ALA-PDT、高频电刀联合ALA-PDT及单纯使用ALA-PDT治疗.治疗后观察创面愈合情况和时间;1年后观察肿瘤复发、疤痕形成、外观效果等情况.结果:74例患...     

5-氨基酮戊酸光动力疗法治疗基底细胞癌80例临床分析

目的探讨光动力疗法(PDT)治疗基底细胞癌(BCC)的临床疗效。方法对本科2009年3月-2011年9月收治的80例BBC病例资料进行回顾性分析,总结临床疗效与治疗的不良反应。结果 80例BBC患者经PDT治疗3个疗程后,痊愈59例,显效12例,好转2例,无效7例,有效率88.75%;病例平均随访18个月,1年后复发15例(18.75%),再次行PDT治疗后,患者均完全缓解;且患者在治疗过程中也无严重不良反应。结论 PDT治疗BCC安全有效、治愈率高且不良反应少,值得临床选用。     

5-氨基酮戊酸光动力治疗面部鳞状细胞癌一例

患者,男,94岁.左颞部粉红色斑块2年.组织病理示:鳞状细胞癌.共接受光动力治疗3次(功率90 mW/cm2,照射时长25 min,间隔7日),治疗后面部皮损恢复良好,定期随访未见复发.     

5-氨基酮戊酸光动力治愈基底细胞癌1例

临床资料患者,女,57岁。因左侧鼻翼部皮疹伴痒8个月于2012年9月21日来我院就诊。患者于8个月前无明显诱因左侧鼻翼部出现米粒大红色丘疹,后逐渐增大隆起呈斑块,斑块中央渐发生糜烂、渗液形成黑色结痂,伴有皮肤瘙痒,于当地医院诊断为湿疹,具体治疗和用药史不详,疗效不佳。病情持续发展,逐渐向外周扩展,渗液增多,瘙痒加重。为     

5-氨基酮戊酸光动力疗法治疗皮肤癌临床观察

目的 探讨5-氨基酮戊酸光动力疗法(ALA-PDT)治疗皮肤癌的疗效.方法 14例患者首次接受ALA-PDT治疗.其中11例基底细胞癌(BCC),2例基底-鳞状细胞癌(BSCC),1例鳞状细胞癌(SCC).结果 经过1-4次ALA-PDT治疗后,所有病例均获得完全反应(CR).随访8～15个月,11例BCC患者1例复发.余病人未见复发.结论 ALA-PDT对皮肤癌具有疗效好、无痛苦、无创伤、无疤痕形成、复发率低的特点.尤其适用于年迈体弱及特殊部位的皮肤肿瘤患者.     

δ－氨基酮戊酸光动力疗法治疗皮肤基底细胞癌和鳞状细胞癌

δ-氨基酮戊酸(δａｍｉｎｏｌｅｖｕｌｉｎｉｃａｃｉｄ,ＡＬＡ)是一种体内血红蛋白合成过程的前身物。正常情况下,ＡＬＡ在细胞内的量很小,本身不产生光敏性。外源性ＡＬＡ进入体内后,可被恶性肿瘤细胞或生长速度快的细胞选择性吸收,并在细胞内转化为原卟啉Ⅸ(ＰｐⅨ)等卟啉类物质[1]。而细胞内的ＰｐⅨ则是一种很强的光敏剂,经过特定波长的红光照射后即发生光动力反应,产生活性氧如单态氧(1Ｏ2)等而杀死肿瘤细胞;而邻近正常组织细胞则不受任何影响。ＡＬＡ介导的光动力疗法(ｐｈｏｔｏｄｙｎａｍｉｃｔｈｅｒａｐｙ,ＰＤＴ)正是在这种理…     

5-氨基酮戊酸光动力疗法治疗皮肤浅表恶性肿瘤疗效观察

基底细胞癌、鲍恩病好发于老年人或长期接触砷剂者,皮损进展缓慢,多数患者发病数年后就诊,部分患者皮损面积较大.     

艾拉光动力治疗基底细胞癌15例疗效观察

目的观察光动力疗法治疗基底细胞癌(BCC)的临床疗效。方法 15例BCC患者予5-氨基酮戊酸(ALA)涂于皮损处3h~4h后行红光照射治疗约30min,能量密度范围在80~180J/cm2内,2周治疗一次,至少治疗4次。结果经4~10次治疗,15例BCC痊愈11例,部分反应3例,无效1例,有效率93.3%。结论对于年龄大、特殊部位、手术困难的老年BCC,PDT是可以考虑的有效替代治疗手段。     

光动力疗法联合微波治疗耳部基底细胞癌一例

<正>临床资料患者,男,54岁。因左耳后皮损渐增多半年余,于2012年6月就诊。患者年幼时左耳后因"疖肿"(具体不详)行局部手术治疗,术后遗留瘢痕;半年余前该瘢痕附近出现一枚粟米大黑色丘疹,皮损渐增大增多,沿外耳郭出现线状排列的多个肤色至灰黑色丘疹及结节,触碰后易出血,自觉轻度瘙痒及疼痛,偶有头晕等不适。既往体健。系统查体无异常。皮肤科情况:左耳后及耳郭外侧见线状排列的粟米至黄豆大肤色、黑色丘疹和结节,部分肤色丘疹内见不均匀黑色颗粒(图1),质硬,轻触痛。实验室及     

5-氨基酮戊酸光动力疗法治疗癌前期皮肤病及皮肤肿瘤疗效观察

<正>1资料与方法 1.1临床资料29例患者均为2007年9月-2009年12本科门诊患者,男17例,女12例,年龄46～89岁,病程3个月～7年。其中日光性角化病9例,Bowen病7例,BCC6例,其中浅表型BCC4例,结节型基底细胞癌1例,腺样型BCC1例,SCC4例,其中I型SCC1例,II型SCC3例,Paget病3例。皮疹分布于头面部、颈部、躯干及外阴部,无手足部皮损。     

Topical photodynamic therapy in clinical dermatology

The growing incidence of cutaneous malignancies each year necessitates the development of new and more effective methods for both the diagnosis and the treatment of cancerous lesions, while assuring better cosmetic results and improving patient satisfaction. With that in mind, the use of topical photodynamic therapy (PDT) has been explored in the treatment as well as the diagnosis of various cutaneous malignancies. Using the intrinsic cellular haem biosynthetic pathway and principles of photoillumination, topical PDT carries the goal of selectively targeting abnormal cells, while preserving the normal surrounding structures. This paper will discuss the various applications and data on the use of topical PDT in dermatology.     

Photodynamic therapy with meta-tetrahydroxyphenylchlorin for basal cell carcinoma: a phase I/II study

BACKGROUND: Photodynamic therapy (PDT) is a convenient and effective method of treating small superficial tumours. New second-generation photosensitizers offer some advantages over first-generation sensitizers such as haematoporphyrin derivatives. OBJECTIVES: To define the optimal treatment parameters (drug dose, light dose and time interval) using meta-tetrahydroxyphenylchlorin (mTHPC) as a photosensitizer in patients with multiple basal cell carcinomas (BCCs). METHODS: Light of 652 nm (100 mW cm(-2)) was used for illuminating different tumours (n = 187) with light doses of 5--15 J cm(-2). Following an intravenous injection of 0.1 mg kg(-1) mTHPC each patient (n = 5) was illuminated on 4 consecutive days. Each day at least three BCCs per patient were treated with PDT. RESULTS: Response evaluation at 6, 12 and 18 months showed maximum responses for illumination with 10 or 15 J cm(-2) on days 1 or 2 after injection (86% complete responses). Normal tissue reactions (oedema and erythema) around the treatment site were more severe on day 1 than after longer intervals. CONCLUSIONS: mTHPC is a very effective photosensitizer; short illumination times can result in long-term cures with good cosmetic healing and with skin phototoxicity of short duration.     

Photodynamic therapy for the treatment of a giant superficial basal cell carcinoma

A 74-year-old man was referred to our department for the treatment of a 15 × 15 cm superficial basal cell carcinoma (BCC) on his lumbar region. As surgical excision was considered too destructive, photodynamic therapy (PDT) was proposed. Methyl 5-aminolevulinate (MAL) cream was applied under occlusion for 3 h before illumination with a light-emitting diode lamp with an emission peak of 632 nm, a fluence rate of 83.3 mW/cm, and a light dose of 37 J/cm. A second MAL-PDT session was repeated 1 week later. The neoplastic area healed in 30 days. No recurrence has occurred after a 40-month follow-up period, but clinical observation continues. Although surgery still remains the treatment of choice for giant BCC, for which the local invasiveness and metastatic potential are well known, we offered our patient the option of PDT because we believed that classical surgery could hardly provide the same satisfactory outcome. As far as we know, this is the first case of giant BCC treated with PDT.     

Treatment of Nevoid Basal Cell Carcinoma Syndrome by Surgery Combined With ALA-PDT: A Case Report

Introduction:Nevoid basal cell carcinoma syndrome is an autosomal dominant disorder characterized by developmental malformations and carcinogenic activity.Multi...     

Photodynamic therapy with topical methyl aminolaevulinate for 'difficult-to-treat' basal cell carcinoma

BACKGROUND: Basal cell carcinoma (BCC) may be difficult to treat by conventional means, particularly if the lesions are large or located in the mid-face (H-zone). Photodynamic therapy (PDT) using topical methyl aminolaevulinate (MAL) may be a good noninvasive option for these patients. OBJECTIVES: To investigate the efficacy and safety of PDT using MAL for BCCs defined as 'difficult to treat', i.e. large lesions, in the H-zone, or in patients at high risk of surgical complications. METHODS: This was a prospective, multicentre, noncomparative study. Patients were assessed 3, 12 and 24 months after the last PDT treatment. One hundred and two patients with 'difficult-to-treat' BCC were treated with MAL PDT, using 160 mg g(-1) cream and 75 J cm(-2) red light (570-670 nm), after lesion preparation and 3 h of cream exposure. Results Ninety-five patients with 148 lesions were included in the per protocol analysis. The histologically confirmed lesion complete response rate at 3 months was 89% (131 of 148). At 12 months, 10 lesions had reappeared, and therefore the cumulative treatment failure rate was 18% (27 of 148). At 24 months, an additional nine lesions had reappeared, resulting in a cumulative treatment failure rate of 24% (36 of 148). The estimated sustained lesion complete response rate (assessed using a time-to-event approach) was 90% at 3 months, 84% at 12 months and 78% at 24 months. Overall cosmetic outcome was judged as excellent or good in 79% and 84% of the patients at 12 and 24 months, respectively. Follow-up is continuing for up to 5 years. CONCLUSIONS: MAL PDT is an attractive option for 'difficult-to-treat' BCC. Because of the excellent cosmetic results, the treatment is particularly well suited for lesions that would otherwise require extensive surgical procedures.     

Fractionated 5-aminolaevulinic acid-photodynamic therapy vs. surgical excision in the treatment of nodular basal cell carcinoma: results of a randomized controlled trial

Background Skin cancer incidence rates have been increasing for decades and this increase is expected to continue. Surgical excision (SE) is the treatment of first choice for nodular basal cell carcinoma (nBCC). Photodynamic therapy (PDT) has proven to be an effective treatment for superficial basal cell carcinoma. Its long‐term efficacy in nBCC has not yet been established. Objectives Prospectively compare the efficacy of 5‐aminolaevulinic acid (ALA)–PDT and SE in terms of failure rates with long‐term follow‐up. Determinants of failure in the study population, such as the effect of tumour depth, were analysed retrospectively. Methods A randomized controlled trial in 173 primary nBCCs in 149 patients. Primary nBCCs were randomly assigned either to PDT (n = 85) or to SE (n = 88). Tumours treated with PDT were illuminated twice on the same day, 4 h after application of ALA cream, 3 weeks after debulking. SE was performed under local anaesthesia with a 3‐mm margin, followed by histological examination. An intention‐to‐treat analysis was performed. Results In total, 171 primary nBCCs in 149 patients were treated. A 3‐year interim analysis revealed that the cumulative incidence of failure was 2·3% for SE and 30·3% for PDT (P < 0·001). Tumour depth and other analysed determinants of failure were not significantly related to treatment failure. Conclusions SE proved to be significantly more effective than treatment with fractionated illumination ALA–PDT. Therefore, in the treatment of primary nBCC, SE is preferred over PDT following this treatment regimen.     

Pulsed ultrasound measurements of depth and regression of basal cell carcinomas after photodynamic therapy: relationship to probability of 1-year local control

BACKGROUND: The regression of clinical basal cell carcinoma (BCC) after photodynamic therapy (PDT) is poorly understood, but is potentially important when, as is increasingly the case, a second treatment is contemplated. High-frequency pulsed ultrasound provides noninvasive information on skin and lesion thickness. OBJECTIVES: To relate pulsed ultrasound measurements before and after PDT to the probability of local control of BCC by PDT. METHODS: Skin thickness and lesion thickness were measured by 20-MHz pulsed ultrasound in 181 patients diagnosed as having BCC. Maximal lesion thickness was determined by repeatedly sampling the BCCs. Measurements were made immediately prior to PDT with aminolaevulinic acid plus 630 nm visible light, and then at 1, 6 and 12 months. RESULTS: Skin thickness in individual patients did not vary with time in this study (mean +/- SD 2.3 +/- 0.6 mm; P = 0.8). In contrast, BCC mean +/- SD maximal thickness 4-6 weeks after PDT was significantly smaller than pretreatment (0.6 +/- 0.8 mm vs. 1.3 +/- 0.8 mm; P < 0.001). The overall probability of 1-year local control fell from 85% when only BCCs 相似文献