Basset-Seguin Nicole, Ibbotson Sally H, Emtestam Lennart, Tarstedt Mikael, Morton Colin, Maroti Marianne, Calzavara-Pinton Piergiacomo, Varma Sandeep, Roelandts Rik, Wolf Peter
Service de dermatologie, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010 Paris, France.
Eur J Dermatol. 2008 Sep-Oct;18(5):547-53. doi: 10.1684/ejd.2008.0472. Epub 2008 Aug 8.
This multicentre, randomized study compared photodynamic therapy using topical methyl aminolaevulinate (MAL PDT), a non-invasive modality, with cryotherapy for treatment of superficial basal cell carcinoma. Sixty patients with 114 lesions were treated with MAL cream (160 mg/g) applied for 3 hours before illumination (570-670 nm, light dose 75 J/cm) (1 session), and 58 with 105 lesions received cryotherapy (2 freeze-thaw cycles). Patients with an incomplete response at 3 months received 2 further MAL PDT sessions (n = 20) or repeat cryotherapy (n = 16). 100 lesions treated with MAL PDT and 93 lesions treated with cryotherapy were in complete response at 3 months after the last treatment and evaluable for recurrence over 5 years. There was no difference in 5-year recurrence rates with either treatment (20% with cryotherapy vs. 22% with MAL PDT, p = 0.86). However, more patients had an excellent cosmetic outcome with MAL PDT (60% vs. 16% with cryotherapy, p = 0.00078). These results provide support for the use of MAL PDT as a non-invasive, selective treatment alternative for primary superficial basal cell carcinoma.
这项多中心随机研究比较了使用外用氨基乙酰丙酸（MAL光动力疗法）这种非侵入性方式与冷冻疗法治疗浅表基底细胞癌的效果。114个病灶的60例患者接受了MAL乳膏（160mg/g）治疗，在光照前（570 - 670nm，光剂量75J/cm²）涂抹3小时（1个疗程），105个病灶的58例患者接受了冷冻疗法（2个冻融周期）。3个月时反应不完全的患者又接受了2次MAL光动力疗法治疗（n = 20）或重复冷冻疗法（n = 16）。最后一次治疗后3个月，100个接受MAL光动力疗法治疗的病灶和93个接受冷冻疗法治疗的病灶完全缓解，可评估其超过5年的复发情况。两种治疗方法的5年复发率无差异（冷冻疗法为20%，MAL光动力疗法为22%，p = 0.86）。然而，更多接受MAL光动力疗法的患者获得了极佳的美容效果（60% vs. 冷冻疗法的16%，p = 0.00078）。这些结果为使用MAL光动力疗法作为原发性浅表基底细胞癌的非侵入性、选择性治疗选择提供了支持。
