Long-Term Recurrence of Nonmelanoma Skin Cancer after Topical Methylaminolevulinate Photodynamic Therapy in a Dermato-Oncology Department

Cabete, J; Rafael, M; Cravo, M; Moura, C; Sachse, F; Pecegueiro, M

http://hdl.handle.net/10400.17/2357

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Abstract(s)

BACKGROUND: Most available studies on the efficacy of topical photodynamic therapy focus on short-to medium-term results. Long-term data are scarce. OBJECTIVE: To evaluate the long-term efficacy of photodynamic therapy with topical methylaminolevulinate to treat Bowen's disease and basal cell carcinoma in the clinical practice setting of a dermato-oncology department. METHODS: The study included patients diagnosed with Bowen's disease or basal cell carcinoma, and who received photodynamic therapy from 2004 to 2008. Treatment protocol and clinical follow-up were standardized. The primary endpoint was clinically observed recurrence in a previous photodynamic therapy-treated area. Descriptive and survival analyses were performed. RESULTS: A total of 31 Bowen's disease lesions and 44 superficial basal cell carcinoma were treated, with a median follow-up of 43.5 months. Recurrence was observed in 14 Bowen's disease lesions (53.8%) and in 11 superficial basal cell carcinoma (33.3%). Significantly higher estimates for recurrence rates were found in patients with Bowen's disease (p=0.0036) or those aged under 58 years (p=0.039). The risk of recurrence was higher in patients with Bowen's disease than in those with superficial basal cell carcinoma and younger patients. CONCLUSIONS: Recurrence should be considered when choosing to treat non-melanoma skin cancer with photodynamic therapy. Younger age and Bowen's disease were independent predictors for long-term recurrence, suggesting the need to establish an extended period of follow-up for this subset of patients.

Keywords

HSAC DER Administration, Cutaneous Age Factors Aminolevulinic Acid/analogs & derivatives Aminolevulinic Acid/therapeutic use Bowen's Disease/drug therapy Carcinoma, Basal Cell/drug therapy Follow-Up Studies Neoplasm Recurrence, Local Photochemotherapy/methods Photosensitizing Agents/therapeutic use Retrospective Studies Risk Assessment Skin Neoplasms/drug therapy Statistics, Nonparametric Time Factors Treatment Outcome