Departments of Dermatology, Hospital Costa del Sol, Marbella, Spain.
Department of Statistics, Hospital Costa del Sol, Marbella, Spain.
Photodermatol Photoimmunol Photomed. 2019 Jul;35(4):208-213. doi: 10.1111/phpp.12453. Epub 2019 Feb 21.
Photodynamic treatment with methyl aminolevulinate (MAL-PDT) is considered an effective and highly recommended treatment for Bowen's disease. However, its long-term efficacy remains to be established, as significant differences have been reported in this respect.
The aim of the present study was to describe the results of a retrospective analysis of patients with Bowen's disease treated with MAL-PDT during the period 2006-17 at the Costa del Sol Hospital (Marbella, Spain).
This study is based on a retrospective descriptive analysis of the clinical records of patients treated with MAL-PDT from June 2006 to September 2017. The analysis was based on calculating the mean and standard deviation values for the quantitative variables, and frequency distributions for the qualitative ones. The survival curves were plotted by the Kaplan-Meier method, and the log-rank test was used to assess differences in survival between groups. A cox regression analysis was performed to clarify the significant prognostic factors.
A total of 537 tumours with histologically confirmed Bowen's disease were treated with MAL-PDT. Recurrence-free survival at one year was 88%, and at 5 years, 71%. Tumour size >300 mm (≥21 mm in diameter P = 0.019), its location in the upper extremities (P = 0.029) and patient's age <70 years (P = 0.028) were all associated with an increased risk of recurrence.
Given the retrospective design of our study, the possible existence of information bias cannot be ruled out.
Although it is an appropriate treatment option for patients with Bowen's disease, MAL-PDT presents a risk of recurrence of almost 30% at 5 years. Larger lesions (>300 mm ; ≥21 mm in diameter) are more likely to recur than smaller ones. Therefore, appropriate selection is needed of the tumour to be treated, and prolonged follow-up should be provided.
光动力疗法（PDT）联合 5-氨基酮戊酸（MAL-PDT）治疗鲍恩病（Bowen's disease）被认为是一种有效且高度推荐的治疗方法。然而，其长期疗效仍有待确定，因为在这方面已有报道存在显著差异。
本研究旨在描述 2006 年至 2017 年期间在西班牙马贝拉科斯塔德尔索尔医院（Costa del Sol Hospital）接受 MAL-PDT 治疗的鲍恩病患者的回顾性分析结果。
本研究基于 2006 年 6 月至 2017 年 9 月期间接受 MAL-PDT 治疗的患者临床记录的回顾性描述性分析。分析基于计算定量变量的平均值和标准差，以及定性变量的频率分布。通过 Kaplan-Meier 法绘制生存曲线，并采用对数秩检验比较组间生存差异。进行 Cox 回归分析以明确显著的预后因素。
共对 537 个经组织学证实的鲍恩病肿瘤进行了 MAL-PDT 治疗。1 年无复发生存率为 88%，5 年无复发生存率为 71%。肿瘤大小>300mm（直径≥21mm，P=0.019）、位于上肢（P=0.029）和患者年龄<70 岁（P=0.028）均与复发风险增加相关。
鉴于本研究的回顾性设计，不能排除存在信息偏倚的可能性。
尽管 MAL-PDT 是鲍恩病患者的一种合适的治疗选择，但 5 年内复发率仍接近 30%。较大的病变（>300mm；直径≥21mm）比较小的病变更容易复发。因此，需要对拟治疗的肿瘤进行适当选择，并提供长期随访。
