Departments of Dermatology Radiology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
J Eur Acad Dermatol Venereol. 2011 Apr;25(4):475-8. doi: 10.1111/j.1468-3083.2010.03757.x.
Topical 5-aminolevulinic acid photodynamic therapy (ALA-PDT) is widely used for treating Bowen's disease (BD), but recurrence and tumour cell persistence after ALA-PDT is sometimes problematic. Radiation therapy (RT) is also effective for BD, but is limited by its side-effects, such as refractory ulcers.
The objective of the study was to observe a synergic effect of combination therapy with ALA-PDT and RT for BD cases that did not respond effectively to prior ALA-PDT.
Subjects were BD patients whose lesion did not show complete remission or showed recurrence after prior ALA-PDT. A total of four cases involving four lesions were studied (three male and one female, mean age 69.5). ALA ointment (20%) was applied to the lesions. After 4 to 6h, subjects received combination therapy consisting of excimer-pumped dye laser radiation at 630nm (50J/cm(2) ) followed by electron-beam radiation (3Gy). The combination therapy was repeated every 2 to 3days for a total of four treatments. The lesions were evaluated clinically or histologically after the final combination therapy session.
Following combination therapy, all of the lesions disappeared. Recurrence was not detected during the observations periods, which averaged 14.0months in duration.
Our results indicate that the cure rate of BD could be improved by combination therapy with ALA-PDT and RT. Compared with conventional RT, the synergetic effect of this therapy might reduce the dose of radiation required, thereby also reducing skin side-effects such as refractory ulcers.
局部外用 5-氨基酮戊酸光动力疗法（ALA-PDT）被广泛用于治疗 Bowen 病（BD），但 ALA-PDT 后复发和肿瘤细胞残留有时是个问题。放射治疗（RT）对 BD 也有效，但受到其副作用的限制，如难治性溃疡。
本研究的目的是观察 ALA-PDT 和 RT 联合治疗对先前 ALA-PDT 治疗效果不佳的 BD 病例的协同作用。
研究对象为病变未完全缓解或先前 ALA-PDT 后复发的 BD 患者。共研究了 4 例 4 处病变（3 例男性，1 例女性，平均年龄 69.5 岁）。将 ALA 软膏（20%）涂于病变处。4 至 6 小时后，患者接受联合治疗，包括 630nm 准分子泵浦染料激光辐射（50J/cm²）和电子束辐射（3Gy）。联合治疗每 2 至 3 天重复一次，共进行 4 次治疗。最后一次联合治疗后，对病变进行临床或组织学评估。
联合治疗后，所有病变均消失。在平均 14.0 个月的观察期内未发现复发。
我们的结果表明，ALA-PDT 和 RT 联合治疗可提高 BD 的治愈率。与常规 RT 相比，这种治疗的协同作用可能减少所需的辐射剂量，从而减少难治性溃疡等皮肤副作用。
