Long-term outcome of photodynamic therapy with hexyl aminolevulinate, 5-aminolevulinic acid nanoemulsion and methyl aminolevulinate for low-risk Basal Cell Carcinomas

IF 3.1 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-02-01 DOI:10.1016/j.pdpdt.2024.104432

M. Salmivuori , M. Grönroos , T. Tani , J. Räsänen , E. Snellman , N. Neittaanmäki

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引用次数: 0

Abstract

Background

Non-surgical treatments are cost-effective options for low-risk basal cell carcinomas (BCCs) i.e. superficial or small nodular BCCs located outside the high-risk locations. Hexyl aminolevulinate (HAL) and 5-aminolevulinic acid nanoemulsion (BF-200 ALA) with enhanced penetration depth enables the use of lower concentrations compared to methylaminolevulinate (MAL) in photodynamic therapy (PDT). We have previously reported comparable short-term efficacies for MAL 16 %, BF-200 ALA 7.8 % and HAL 2 % in PDT of low-risk BCC, and here we report the long-term results.

Objectives

The goal of this trial was to compare long-term outcomes of HAL and BF-200 ALA, compared to MAL in PDT of low-risk BCCs.

Methods

Ninety-eight histologically verified low-risk BCCs on the trunk or extremities were included and randomized into three arms to receive PDT in two sessions with MAL, BF-200 ALA or HAL. A blinded dermatologist assessed the response, cosmetic outcome, and obtained biopsies for histological verification at three months, one year and five years. Histologically verified non-responsive lesions were excised. Patients’ satisfaction with the treatment was also queried.

Results

According to intention-to-treat (ITT) analyses, the cumulative response rate at one year was 90.6 % for MAL, 81.3 % for BF-200 ALA, and 75.8 % for HAL, and correspondingly at five years 71.9 %, 54.6 % and 60.6 %. There were no statistically significant differences between interventions and comparator. The overall cumulative response rate for PDT was 82.5 % at one year and 62.2 % at five, and 48.6 % of the treatment failures were recorded at five years. The recurrent lesions were excised as second line treatment. No aggressive subtypes were reported, with only superficial or nodular growth in the final histopathological report. There were no significant differences in cosmetic outcome or patient satisfaction.

Conclusions

This trial shows that HAL has potential for dermatological PDT. However, the long-term efficacy of PDT in the treatment of low-risk BCCs remains rather low.

Abstract Image

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氨基乙酰丙酸己酯、5-氨基乙酰丙酸纳米乳和氨基乙酰丙酸甲酯光动力治疗低危基底细胞癌的长期疗效

背景：对于低风险基底细胞癌（bcc），即位于高危部位以外的浅表性或小结节性基底细胞癌，非手术治疗是经济有效的选择。与甲氨基乙酰丙酸（MAL）相比，具有增强渗透深度的己基氨基乙酰丙酸（HAL）和5-氨基乙酰丙酸纳米乳（BF-200 ALA）在光动力治疗（PDT）中使用的浓度更低。我们之前报道过低风险BCC PDT中MAL的短期疗效为16%，BF-200 ALA为7.8%，HAL为2%，这里我们报告的是长期结果。目的：本试验的目的是比较HAL和BF-200 ALA与MAL在低风险bcc PDT中的长期结果。方法：纳入98例经组织学证实的躯干或四肢低风险bcc，随机分为三组，分别在MAL、BF-200 ALA或HAL两组接受PDT治疗。一名盲法皮肤科医生评估了患者的反应、美容结果，并在3个月、1年和5年进行了组织学检查。组织学证实无反应的病变被切除。同时询问患者对治疗的满意度。结果：意向治疗（ITT）分析显示，1年累积缓解率MAL为90.6%，BF-200 ALA为81.3%，HAL为75.8%，5年累积缓解率分别为71.9%、54.6%和60.6%。干预组与比较组之间无统计学差异。PDT的总累积缓解率在1年为82.5%，5年为62.2%，48.6%的治疗失败记录在5年。复发病灶切除作为二线治疗。没有侵袭性亚型的报道，只有浅表或结节生长在最终的组织病理学报告。在美容效果或患者满意度方面没有显著差异。结论：本试验表明HAL有可能用于皮肤病PDT。然而，PDT治疗低风险bcc的长期疗效仍然很低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.