5-氨基酮戊酸光动力治疗皮肤肿瘤的疗效观察

目的评价5-氨基酮戊酸光动力(ALA-PDT)治疗日光性角化病、Bowen病、基底细胞癌和鳞状细胞癌的临床疗效。方法将光敏剂5-氨基酮戊酸(ALA)涂于53例日光性角化病、23例Bowen病、36例基底细胞癌、40例鳞状细胞癌患者的皮损处,避光3~4h后,使用光动力治疗仪照射约20min,1次/周,经4~6次治疗后评估疗效。结果 ALA-PDT疗法治疗日光性角化病及Bowen病的有效率为100%;基底细胞癌浅表型的疗程短(3~5次),且有效率为100%,结节型疗程长(4~6次),且有效率仅为77.77%;高分化鳞癌有效率为100%,中分化为85.71%,低分化鳞癌有效率为40.00%,所有皮肤肿瘤患者的总痊愈率为84.21%,有效率为95.35%。结论 ALA-PDT治疗日光性角化病、Bowen病、浅表型基底及高分化鳞状细胞癌疗效确切,美容效果佳,无不良反应,治疗结节性基底细胞癌及中分化、低分化鳞状细胞癌尤其是年老体弱、美容要求高的患者亦有一定的疗效。     

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...     

光动力疗法治疗皮肤肿瘤疗效观察

目的 观察盐酸氨基酮戊酸光动力疗法(ALA-PDT)治疗皮肤癌前病变和皮肤癌的疗效.方法 对17例光线性角化病、10例基底细胞癌和7例鲍温病患者进行ALA-PDT治疗:20%ALA霜剂涂于皮损;4h后激光照射.能量密度为100~120J/cm2,时间约40 min.结果 随访6～12个月,17例光线性角化病患者皮损获得完全缓解,无复发;10例基底细胞癌患者的皮损,8例获完全缓解.1例获部分缓解,1例无反应,3例平均于治疗后6个月复发;7例鲍温病患者皮损,6例获得完全缓解,1例部分缓解.1例于治疗后8个月复发.结论 ALA-PDT是一种疗效好、无明显痛苦、无瘢痕形成、复发率低、美容效果好的治疗皮肤肿瘤的新疗法.     

梅花针叩刺增强氨基酮戊酸光动力治疗光线性角化病、基底细胞癌、鳞状细胞癌的研究

目的 探讨梅花针叩刺预处理对氨基酮戊酸光动力（ALA-PDT）治疗光线性角化病、基底细胞癌、鳞状细胞癌的疗效影响,以及梅花针叩刺预处理的安全性。 方法 通过病例对照研究,对6例光线性角化病,3例结节型基底细胞癌,3例原位鳞状细胞癌进行梅花针叩刺 ＋ ALA-PDT治疗,同时选取皮损类型及分期类似的患者仅单纯ALA-PDT治疗作为对照组。 结果 梅花针叩刺 ＋ ALA-PDT治疗组单次治疗对光线性角化病的完全缓解率明显高于单纯ALA-PDT组［1级皮损12/12比10/14,2级皮损79.5%（31/39）比57.9%（22/38）,3级皮损36.6%（15/41）比17.0%（7/41）,均P ＜ 0.05］。梅花针叩刺 ＋ ALA-PDT治疗组中光线性角化病获得完全缓解所需的治疗次数有所减少,3级皮损平均治疗1.9次获得完全缓解;单纯ALA-PDT组3级皮损平均2.6次获得完全缓解。梅花针叩刺 ＋ ALA-PDT治疗原位皮肤鳞状细胞癌（皮损厚度超过0.3 mm）,获得完全缓解治疗次数少于单纯ALA-PDT组。结节型基底细胞癌在增加梅花针叩刺后治疗效果亦增强。梅花针叩刺患者疼痛无明显增加。 结论 梅花针叩刺可增强ALA-PDT治疗光线性角化病,基底细胞癌,鳞状细胞癌的疗效,而不增加不良反应。     

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.     

光动力疗法治疗皮肤鳞状上皮细胞癌7例疗效观察

目的观察5-氨基酮戊酸光动力疗法(ALA-PDT)治疗皮肤鳞状细胞癌的临床疗效和复发率。方法对7例经组织病理学确诊的皮肤鳞状细胞癌进行(ALA-PDT治疗。结果经(3~6)次治疗后,7例患者溃疡面均被肉芽组织覆盖后愈合。随访6月后,均未发现原皮损处复发,2例患者治疗部位有轻度刺痛、瘙痒。结论对皮肤鳞状细胞癌尤其老年患者,ALA-PDT疗法损伤小、美容效果好。     

5-氨基酮戊酸光动力疗法治疗27例皮肤肿瘤疗效观察

目的探讨5-氨基酮戊酸光动力疗法(ALA-PDT)治疗皮肤肿瘤的临床疗效。方法对27例患者进行ALA-PDT治疗,其中包括角化棘皮瘤5例,光线性角化病12例,鲍恩病6例,增殖性红斑2例,疣状癌、鳞状细胞癌各1例。结果经过3~5次ALA-PDT治疗,角化棘皮瘤患者5例、光线性角化病患者11例、鲍恩病患者5例、增殖性红斑患者2例完全缓解,仅1例光线性角化病患者复发;疣状癌治疗无效;鳞状细胞癌完全缓解后又复发。结论 ALA-PDT因疗效好、损伤小、美容效果好、复发率低,适合皮损面积大、病变部位特殊的部分皮肤肿瘤,但对疣状癌、鳞状细胞癌效果欠佳。     

皮肤磨削术联合氨基酮戊酸光动力疗法治疗鼻部结节型基底细胞癌25例

目的 探讨皮肤磨削术联合氨基酮戊酸光动力疗法（ALA-PDT）治疗鼻部结节型基底细胞癌（BCC）的疗效。 方法 25例经病理确诊、皮损面积 > 1 cm2、无骨或软骨侵犯的鼻部结节型BCC患者,实施皮肤磨削术联合ALA-PDT治疗。首先去除肿瘤病灶（对于突出皮肤表面的病灶先实施切削术,然后实施磨削术）,术后创面即刻避光条件下外敷20%氨基酮戊酸3 ~ 4 h,然后平均100 J/cm2 LED光照射20 min。ALA-PDT每周1次,连续3周。术后观察创面愈合情况和时间;1年后随访观察肿瘤复发、瘢痕形成、外观效果等情况,并做出综合评价。 结果 25例患者未见创面感染,平均创面愈合时间为（11.2 ± 1.3） d。术后1年未见复发病例;1例患者发生瘢痕挛缩,3例患者有轻度的瘢痕增生,4例患者遗留凹陷性瘢痕。除1例患者对术后外观基本满意外,24例患者均对术后外观满意。 结论 皮肤磨削术联合ALA-PDT治疗鼻部结节型BCC操作简便,创面愈合快,术后复发率低,患者满意度高,值得临床推广。     

5-氨基酮戊酸光动力疗法治疗泛发性跖疣28例疗效观察

目的 观察5-氨基酮戊酸光动力疗法(ALA-PDT)治疗泛发性跖疣的临床疗效.方法 对28例泛发性跖疣患者进行ALA-PDT治疗.结果 经过(3~4)次ALA-PDT治疗后,随访3个月,26例泛发性跖疣患者皮损获得完全缓解,2例获得部分缓解,2例患者复发.结论 外用5-氨基酮戊酸光动力治疗泛发性跖疣是一种痛苦小、疗效好、复发率低、副作用轻微的方法.     

5-氨基酮戊酸光动力疗法治疗皮肤癌及皮肤癌前病变疗效观察

目的:观察5-氨基酮戊酸(ALA)-光动力疗法(PDT)治疗部分皮肤癌及癌前病变的疗效.方法:50例患者首次接受ALA-PDT治疗,其中日光性角化病25例、鲍恩样丘疹病16例、鲍恩病4例、基底细胞癌(BCC)4例、口腔鳞状细胞癌1例.结果:经过2-6次ALA-PDT治疗,20例日光性角化病患者痊愈,8例鲍恩样丘疹病患者痊愈,鲍恩病4例中3例痊愈,BCC有3例痊愈,口腔鳞状细胞癌患者病灶面积缩小70%.结论:ALA-PDT治疗部分皮肤癌及癌前病变具有疗效确切、安全、损伤小、无明显不良反应的优势.对于皮损位于特殊部位、惧怕手术及术后瘢痕的患者采用ALA-PDT治疗是较好的选择.     

Aminolevulinic acid photodynamic therapy for skin cancers

Aminolevulinic acid photodynamic therapy (ALA-PDT) is an effective and noninvasive therapy for superficial basal cell carcinoma (BCC) and Bowen's disease. It also may have a role in the treatment of nodular BCC and other cutaneous malignancies, including localized cutaneous lymphomas. ALA-PDT offers multiple advantages over traditional treatments, including little to no scarring, excellent cosmetic results, and the ability to treat multiple lesions simultaneously. It is not an effective therapy for aggressive subtypes of BCC or for invasive squamous cell carcinoma. Finally, ALA-PDT may be a useful way to prevent new skin cancers in certain high-risk patients.     

浅层X线放射治疗基底细胞癌和鳞状细胞癌27例疗效分析

目的：评价浅层X射线治疗皮肤基底细胞癌（BCC）和鳞状细胞癌（SCC）的疗效。方法：回顾分析2014年6月至2017年7月在我院应用浅层X射线治疗的27例原发性BCC(14例)和SCC(13例)患者,所有患者均经过组织病理学确诊,因健康状况、年龄、皮损部位等原因不适用手术而选用浅层X线治疗。结果：27例患者的31处皮损均痊愈,受照总剂量为45.6-53.2 Gy,随访 2年 仅1例患者1处皮损复发。不良反应主要为放射性皮炎及皮损处的溃烂,皮损体积较大者多伴有疼痛,一般1个月内消失。结论：浅层X射线放射治疗SCC和BCC疗效好,复发率低,对因各种原因不适合手术治疗的患者,是较为理想的方法。     

Efficacy of photodynamic therapy with methyl aminolevulinate in the treatment of superficial and nodular basal cell carcinoma: an open-label trial

Photodynamic therapy with methyl aminolevulinate (MAL-PDT) is a non-invasive therapy for superficial and nodular basal cell carcinoma (BCC). We performed an open-label trial to evaluate efficacy, safety, tolerability and cosmetic outcome of MAL-PDT in selected patients with superficial and nodular BCCs. Ninety-four superficial and 24 nodular BCCs in 69 patients were treated with 2 to 8 MAL-PDT sessions. Efficacy, safety, tolerability and cosmetic outcome were evaluated at months 1, 3, 6 and 12 after the last MAL-PDT treatment and then every 3 months. One patient discontinued the study for reasons unrelated to study procedures. Complete clinical regression was detected in 84/94 (89.4%) superficial BCCs, and 12/23 (52.2%) nodular BCCs one month after 2 MAL-PDT sessions. No further clinical improvement was observed in either superficial or nodular BCCs with treatment continuation up to a maximum of 8 MAL-PDT sessions. Adverse effects were limited to mild local skin reactions, and cosmetic outcome was rated as excellent or good. Recurrence was observed in 2/84 (2.4%) successfully treated superficial BCCs at 6 and 12 months after treatment discontinuation. Based on the efficacy, tolerability, cosmetic outcome and recurrence rate, our results support the use of MAL-PDT for treatment of superficial BCC and for selected cases of nodular BCC.     

Clinical investigation of the novel iron-chelating agent, CP94, to enhance topical photodynamic therapy of nodular basal cell carcinoma

Background  Photodynamic therapy (PDT) involves the activation of a photosensitizer by visible light to produce activated oxygen species within target cells, resulting in their destruction. Evidence-based guidelines support the efficacy of PDT using topical 5-aminolaevulinic acid (ALA-PDT) in actinic keratoses, Bowen disease and basal cell carcinoma (BCC). Efficacy for nodular BCC appears inferior to that for superficial BCC unless prior debulking or repeat treatments are performed.
Objectives  The aim of this study was to assess the safety and efficacy of adding a novel iron-chelating agent, CP94 (1,2-diethyl-3-hydroxypyridin-4-one hydrochloride), to topical ALA, to temporarily increase the accumulation of the photosensitizer in the tumour.
Methods  A mixed topical formulation of ALA + increasing concentrations of CP94 was used to carry out PDT on previously biopsied nodular BCC with no prior lesion preparation using standard light delivery. The area was assessed clinically and surgically excised 6 weeks later for histological examination.
Results  Enhanced PDT using 40% CP94 resulted in significantly greater clearance rates in nodular BCC than with ALA-PDT alone, in our protocol of single-treatment PDT with no lesion preparation.
Conclusions  The results of this study demonstrate the safe and effective use of an enhanced ALA-PDT protocol for nodular BCC using CP94, with no adverse reactions to this modification. This is the first time this formulation has been used in patients. This formulation is now the focus of further study.     

Imiquimod 5% cream for the treatment of superficial and nodular basal cell carcinoma: randomized studies comparing low-frequency dosing with and without occlusion

BACKGROUND: Imiquimod 5% cream has been investigated for non-surgical treatment of superficial and nodular basal cell carcinoma (BCC) tumours. OBJECTIVES: Two studies were conducted to examine the effect of occlusion at low dosing frequencies on the safety and efficacy of topical imiquimod 5% cream for the treatment of superficial and nodular BCC. PATIENTS AND METHODS: Both open-label studies were conducted in Europe. Patients diagnosed with BCC were enrolled into either the superficial (93 patients) or nodular (90 patients) study, depending on the histological confirmation of the patient's tumour subtype. Patients were randomized to one of four groups to apply imiquimod 5% cream 2 or 3 days per week either with or without occlusion. Six weeks following a 6-week treatment period, the entire target tumour area was excised and histologically examined for evidence of residual tumour. RESULTS: In both studies, the highest histologically complete response rate was seen in the 3 days per week with occlusion groups, with complete response rates of 87% and 65% for the superficial and nodular studies, respectively. Occlusion did not have a statistically significant effect on response rate at either dosing frequency. Response rates for superficial and nodular BCC tumours treated 3 days per week without occlusion were 76% and 50%, respectively. CONCLUSIONS: In the superficial study, the complete response rate of 87% in the 3 days per week with occlusion group was similar to that of daily and 5 days per week dosing without occlusion in a previous 12-week study and one study of daily dosing without occlusion for 6 weeks. All treatment groups had acceptable safety profiles in both studies. Occlusion did not have a statistically significant effect on efficacy for either superficial or nodular BCC tumours.     

An open-label, pilot study examining the efficacy of curettage followed by imiquimod 5% cream for the treatment of primary nodular basal cell carcinoma

SUMMARY The short-term efficacy of imiquimod 5% cream for the treatment of primary superficial basal cell carcinoma has been established. This study investigated its efficacy following curettage (without electrodesiccation) for the treatment of primary nodular basal cell carcinoma on the trunk and limbs. Seventeen patients with a total of 34 lesions were enrolled. Curettage was used to de-bulk the lesion and confirm suitable histology. Lesions displaying more aggressive subtypes (such as micronodular or morpheoic components) were excluded. Lesions were treated daily for 6 to 10 weeks with imiquimod 5% cream. Three months post treatment all lesions were excised, and 32 of 34 treated lesions (94%) were histologically clear of basal cell carcinoma. Fourteen of 17 patients rated the cosmetic outcome of treatment as excellent or good. Curettage followed by imiquimod 5% cream is effective for the treatment of primary nodular basal cell carcinoma on the trunk and limbs, and most patients are pleased with the cosmetic outcome.     

European guidelines for topical photodynamic therapy part 1: treatment delivery and current indications – actinic keratoses,Bowen’s disease,basal cell carcinoma

Topical photodynamic therapy (PDT) is a widely used non‐invasive treatment for certain non‐melanoma skin cancers, permitting treatment of large and multiple lesions with excellent cosmesis. High efficacy is demonstrated for PDT using standardized protocols in non‐hyperkeratotic actinic keratoses, Bowen’s disease, superficial basal cell carcinomas (BCC) and in certain thin nodular BCC, with superiority of cosmetic outcome over conventional therapies. Recurrence rates following PDT are typically equivalent to existing therapies, although higher than surgery for nodular BCC. PDT is not recommended for invasive squamous cell carcinoma. Treatment is generally well tolerated, but tingling discomfort or pain is common during PDT. New studies identify patients most likely to experience discomfort and permit earlier adoption of pain‐minimization strategies. Reduced discomfort has been observed with novel protocols including shorter photosensitizer application times and in daylight PDT for actinic keratoses.     

Efficacy of imiquimod 5% cream for basal cell carcinoma in transplant patients

Imiquimod 5% cream has proven to be effective in superficial and nodular basal cell carcinomas in nonimmunosuppressed patients and treating squamous cell carcinomas in situ in transplant patients. The objective of this open-label study was to determine the efficacy of imiquimod 5% cream in treating basal cell carcinoma in transplant patients. At our unit, four renal transplant patients and one cardiac transplant patient were diagnosed with 10 basal cell carcinomas in 2001. Four tumours were superficial, three nodular and three infiltrative. Five basal cell carcinomas received imiquimod 5% cream at night four times weekly for 6 weeks, without occlusion, and the other five tumours were treated on 5 nights per week for 5 weeks. Biopsies taken 6 weeks after the end of treatment showed no tumour in seven of 10 of the cases. Notably, all four superficial basal cell carcinomas, two of the three of nodular lesions and one of the three of infiltrative cases had completely cleared.