%0 Journal Article
%T Six Years of Experience in Photodynamic Therapy for Basal Cell Carcinoma: Results and Fluorescence Diagnosis from 191 Lesions
%A M. Fern¨¢ndez-Guarino
%A A. Harto
%A B. P¨¦rez-Garc¨ªa
%A A. Royuela
%A P. Ja¨¦n
%J Journal of Skin Cancer
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/849248
%X Background. Photodynamic therapy (PDT) has become a therapeutic option for basal cell carcinoma (BCC) in the last decade. Objectives. To study the results and predictors of BCC response to treatment with PDT and to evaluate fluorescence diagnosis of BCC. Methods. A descriptive, retrospective, and observational study was carried out. Patients with biopsy-confirmed BCC who were treated with methyl aminolevulinate and red light according to standard treatment protocols (2 sessions separated by 2 weeks, 630£¿nm, 37£¿J/cm2, 8 minutes, Aktilite) were selected. Response was scored as clinically complete and incomplete and the patients were followed up every three months. Results. Data from 191 BCC in 181 patients with a mean age of 69.55 years and a mean follow-up period of 34.4 months were collected. The overall response was 74% of the BCC treated, with the best response in superficial BCC with a 95% of complete response. The regression analysis revealed that the superficial histological type was the primary factor predictive of a complete response. Conclusions. In the treatment of BCC with PDT, the most significant factor for predicting response is the histological type. 1. Introduction PDT with MAL was approved in Europe in 2005 for the treatment of superficial (sBCC) and nodular (nBCC) basal cell carcinoma (BCC) [1]. The results of PDT on BCC have been evaluated in several studies, most of them clinical trials. The cure rates achieved in these studies were 80¨C90% for sBCC [2¨C5] and 52¨C73% for nBCC [2, 3, 6, 7]. The level of recommendation in sBCC treatment guidelines is A with a level of evidence of I and B for nBCC with a level of evidence of I (surgery continues to be the gold standard for nBCC) [8]. However, since its approval, few large retrospective studies that study the results of its daily use and on fluorescence diagnosis have been published [9¨C11]. These studies, though having less statistical power than the clinical trials, reveal new aspects of PDT on BCC by describing what happens in routine clinical practice. This study summarizes the findings of six years of experience in the treatment and fluorescence diagnosis using PDT on BCC in a series of 181 patients and also provides a long follow-up period. 2. Materials and Methods A descriptive, retrospective observational study was carried out between May of 2005 and May of 2011. Data from patients with BCC treated with PDT were collected from three dermatologists at the same center. All of the office visits from the three dermatologists¡¯ schedules were collected using an Excel spreadsheet and
%U http://www.hindawi.com/journals/jsc/2014/849248/