Photodynamic therapy in conjunction with Mohs micrographic surgery for basal cell carcinoma: A scenario-based review

IF 2.6 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-09-16 DOI:10.1016/j.pdpdt.2025.105220

Kevin Varghese, Natalie Behzadpour, Lauren Randall, Atieh Jibbe

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引用次数: 0

Abstract

Background

Basal cell carcinoma (BCC) is the most common skin cancer. Mohs micrographic surgery (MMS) offers the highest cure rates for high-risk or recurrent BCC, while photodynamic therapy (PDT) is effective for superficial and select nodular BCC. Reports describing their combined use are limited and heterogeneous.

Objective

To summarize clinical scenarios in which PDT has been used in conjunction with MMS for BCC and describe reported oncologic and cosmetic outcomes.

Methods

A systematic search of PubMed, Embase, and Scopus was performed to identify English-language studies reporting PDT with MMS for BCC. Eligible studies included patients treated with PDT before, during, or after MMS. Data extracted included tumor characteristics, PDT protocol, timing relative to MMS, outcomes, and adverse events. Due to substantial heterogeneity, results were narratively synthesized by clinical scenario.

Results

Eight studies met inclusion criteria, comprising case reports, case series, and retrospective analyses. PDT was applied preoperatively to debulk tumors, postoperatively to treat residual superficial disease, postoperatively to enhance wound healing, or in special populations such as patients with nevoid basal cell carcinoma syndrome. Across studies, recurrence rates did not significantly differ from MMS alone where assessed. Cosmetic outcomes were variably reported, with high patient satisfaction frequently noted. Adverse effects were generally mild and transient.

Conclusion

Evidence for PDT combined with MMS is limited to small, heterogeneous studies. Current data support selective use in specific scenarios, but further prospective, controlled studies with standardized outcome measures are needed to clarify its role in clinical practice.

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简短的交流：光动力疗法结合Mohs显微摄影手术治疗基底细胞癌：基于场景的回顾。

背景：基底细胞癌（BCC）是最常见的皮肤癌。Mohs显微摄影手术（MMS）对高危或复发性BCC提供最高治愈率，而光动力治疗（PDT）对浅表性和选择性结节性BCC有效。描述它们联合使用的报告是有限的和异构的。目的：总结PDT联合MMS治疗BCC的临床情况，并描述已报道的肿瘤和美容结果。方法：对PubMed、Embase和Scopus进行系统搜索，以确定报道PDT伴MMS的BCC的英语研究。符合条件的研究包括在MMS之前、期间或之后接受PDT治疗的患者。提取的数据包括肿瘤特征、PDT方案、与MMS相关的时间、结局和不良事件。由于存在很大的异质性，结果是根据临床情况叙述合成的。结果：8项研究符合纳入标准，包括病例报告、病例系列和回顾性分析。术前应用PDT去除肿瘤，术后用于治疗残留的浅表疾病，术后用于促进伤口愈合，或用于特殊人群，如痣状基底细胞癌综合征患者。在所有研究中，复发率与单独评估MMS没有显著差异。美容结果的报告各不相同，经常注意到患者的高满意度。不良反应通常是轻微和短暂的。结论：PDT联合MMS的证据仅限于小型、异质性研究。目前的数据支持在特定情况下选择性使用，但需要进一步的前瞻性、标准化结果测量的对照研究来阐明其在临床实践中的作用。

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.