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. 2020 May;82(5):1124-1130.
doi: 10.1016/j.jaad.2019.10.079. Epub 2019 Nov 8.

Photodynamic therapy for cutaneous squamous cell carcinoma in situ: Impact of anatomic location, tumor diameter, and incubation time on effectiveness

Nour Kibbi  1 , Yuemei Zhang  1 , David J Leffell  1 , Sean R Christensen  2
Affiliations

Photodynamic therapy for cutaneous squamous cell carcinoma in situ: Impact of anatomic location, tumor diameter, and incubation time on effectiveness

Nour Kibbi et al. J Am Acad Dermatol. 2020 May.

Abstract

Background: Photodynamic therapy (PDT) has been reported as a treatment for cutaneous squamous cell carcinoma in situ (SCCis), but only limited data are available on the effectiveness of PDT with aminolevulinic acid (ALA-PDT).

Objective: To review the outcomes of SCCis treated with ALA-PDT and examine factors associated with response.

Methods: A retrospective review identified 58 patients with 68 primary SCCis lesions treated with ALA-PDT and blue light illumination. Patient demographics, lesion features, treatment details, clinical response, and subsequent recurrence were extracted from medical record reviews.

Results: On completion of PDT the initial complete response rate was 77.9% and was not associated with the number of PDT treatments. On multivariate analysis factors associated with response were location on the face, tumor diameter <2 cm, and longer ALA incubation time. Lesions treated with a maximum incubation time of <3 hours had a 53.3% response compared with 84.9% for longer incubation. Subsequent recurrence of SCCis was noted in 7 of 53 cases (13.2%) at a median time of 11.7 months.

Limitations: This was a retrospective study performed at a single institution without systematic follow-up.

Conclusions: ALA-PDT may be an effective treatment for selected cases of SCCis. Effectiveness is impacted by anatomic location, tumor diameter, and ALA incubation time.

Keywords: Bowen disease; aminolevulinic acid; humans; photodynamic therapy; retrospective studies; skin neoplasms; squamous cell carcinoma in situ; treatment outcome.

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