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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le mardi 28 janvier 2020
Doi : 10.1016/j.jaad.2019.10.079
accepted : 30 October 2019
Photodynamic therapy for cutaneous squamous cell carcinoma in situ: Impact of anatomic location, tumor diameter, and incubation time on effectiveness
 

Nour Kibbi, MD, Yuemei Zhang, MD, MBA, David J. Leffell, MD, Sean R. Christensen, MD, PhD
 Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut 

Correspondence to: Sean R. Christensen, MD, PhD, Yale Dermatologic Surgery, 40 Temple Street, Suite 5A, New Haven, CT 06510.Yale Dermatologic Surgery40 Temple Street, Suite 5ANew HavenCT06510
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.

The full text of this article is available in PDF format.

Key words : aminolevulinic acid, Bowen disease, humans, photodynamic therapy, retrospective studies, skin neoplasms, squamous cell carcinoma in situ, treatment outcome

Abbreviations used : ALA, ALA-PDT, CR, PDT, SCCis



 Funding sources: Supported by a Career Development Award from the Dermatology Foundation (Dr Christensen).
 Conflicts of interest: None disclosed.
 IRB approval status: Reviewed and approved by the Yale Institutional Review Board (IRB number 2000024076).
 Reprints not available from the authors.



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