光动力疗法治疗皮肤原位鳞状细胞癌：解剖位置、肿瘤直径和潜伏期对疗效的影响。

Photodynamic therapy for cutaneous squamous cell carcinoma in situ: Impact of anatomic location, tumor diameter, and incubation time on effectiveness.

机构信息

Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.

出版信息

J Am Acad Dermatol. 2020 May;82(5):1124-1130. doi: 10.1016/j.jaad.2019.10.079. Epub 2019 Nov 8.

DOI:10.1016/j.jaad.2019.10.079

PMID:31712171

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.

摘要

背景

光动力疗法（PDT）已被报道可用于治疗皮肤原位鳞状细胞癌（SCCis），但仅有有限的数据可用于评估氨基酮戊酸（ALA）-PDT 的疗效。

目的

回顾接受 ALA-PDT 治疗的 SCCis 的结果，并研究与疗效相关的因素。

方法

对接受 ALA-PDT 和蓝光照射治疗的 58 例 SCCis 患者的病例进行回顾性分析，记录患者的人口统计学特征、病变特征、治疗细节、临床反应和随后的复发情况。

结果

完成 PDT 后，初始完全缓解率为 77.9%，与 PDT 治疗次数无关。多变量分析显示，与疗效相关的因素包括病变位置在面部、肿瘤直径<2cm 和更长的 ALA 孵育时间。最大孵育时间<3 小时的病变反应率为 53.3%，而孵育时间较长的病变反应率为 84.9%。53 例中有 7 例（13.2%）在中位时间 11.7 个月后复发 SCCis。