Superficial photodynamic therapy with topical 5-aminolaevulinic acid for superficial primary and secondary skin cancer

• Published in: British journal of cancer 1994-03, Vol.69 (3), p.605-608
• Main Authors: CAIRNDUFF, F, STRINGER, M. R, HUDSON, E. J, ASH, D. V, BROWN, S. B
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - pathology; Adenocarcinoma - secondary; Administration, Topical; Aminolevulinic Acid - administration & dosage; Aminolevulinic Acid - therapeutic use; Aminolevulinic Acid - toxicity; Biological and medical sciences; Bowen's Disease - drug therapy; Bowen's Disease - pathology; Breast Neoplasms - drug therapy; Carcinoma, Basal Cell - drug therapy; Carcinoma, Basal Cell - pathology; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - secondary; Diseases of the skin. Cosmetics; Follow-Up Studies; Humans; Light - adverse effects; Medical sciences; Photochemotherapy - adverse effects; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Skin Neoplasms - drug therapy; Skin Neoplasms - pathology; Skin Neoplasms - secondary; Time Factors
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.1994.112

Between January 1991 and December 1992 a phase I trial of superficial photodynamic therapy (PDT) using topical application of 5-aminolaevulinic acid (ALA) was undertaken to treat Bowen's disease, superficial basal cell carcinomas (BCCs) and metastatic skin secondaries from breast (adenocarcinoma) or pinna (squamous cell carcinoma). Promising results were obtained with 36 areas of Bowen's disease, with a complete response rate of 89% at a median follow-up of 18 months. The treatment of BCCs was less successful, with 50% complete responses in 16 lesions at a median follow-up of 17 months. Metastatic nodules responded poorly. The treatment was well tolerated and discomfort during light irradiation could be reduced by prior application of 'Emla' cream. Lesions wept for 1-2 weeks following treatment and healed over a period of approximately 2 months. For large areas of Bowen's disease, particularly in anatomically difficult areas and in elderly patients, PDT using ALA may constitute a single simple alternative outpatient treatment to existing therapies. Further work is required to improve the results with BCCs.