Center for Clinical and Cosmetic Research, Aventura, Florida, USA.
Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
J Cosmet Dermatol. 2023 Sep;22(9):2471-2475. doi: 10.1111/jocd.15886. Epub 2023 Jun 27.
Squamous cell carcinoma (SCC) is the second most common cutaneous malignancy, after basal cell carcinoma (BCC). Photodynamic therapy (PDT) involves converting a photosensitizer to reactive oxygen intermediates, which preferentially bind to hyperproliferative tissue. The most commonly used photosensitizers are methyl aminolevulinate and aminolevulinic acid (ALA). Presently, ALA-PDT is approved in the US and Canada for the treatment of actinic keratoses on the face, scalp, and upper extremities.
This cohort study evaluated the safety, tolerability, and efficacy of aminolevulinic acid, pulsed dye laser, and photodynamic therapy (ALA-PDL-PDT) for treatment of facial cutaneous squamous cell carcinoma in situ (isSCC).
Twenty adult patients with biopsy-confirmed isSCC on the face were recruited. Only lesions 0.4-1.3 cm in diameter were included. Patients underwent two treatments with ALA-PDL-PDT spaced 30 days apart. The isSCC lesion was then excised 4-6 weeks following the second treatment for histopathological assessment.
No residual isSCC was detected in 17/20 (85%) patients. Two of the patients with residual isSCC had skip lesions present that explained the treatment failure. Excluding the patients with skip lesions, the posttreatment histological clearance rate was 17/18 (94%). Minimal side effects were reported.
Our study was limited by small sample size and lack of long-term recurrence data.
The ALA-PDL-PDT protocol is a safe and well-tolerated treatment option for isSCC on the face, providing excellent cosmetic and functional results.
鳞状细胞癌（SCC）是仅次于基底细胞癌（BCC）的第二大常见皮肤恶性肿瘤。光动力疗法（PDT）涉及将光敏剂转化为活性氧中间体，这些中间体优先与过度增殖的组织结合。最常用的光敏剂是甲基氨基酮戊酸和氨基酮戊酸（ALA）。目前，ALA-PDT 在美国和加拿大被批准用于治疗面部、头皮和上肢的光化性角化病。
本队列研究评估了氨基酮戊酸、脉冲染料激光和光动力疗法（ALA-PDL-PDT）治疗面部原位皮肤鳞状细胞癌（isSCC）的安全性、耐受性和疗效。
招募了 20 名面部活检证实有 isSCC 的成年患者。仅纳入直径为 0.4-1.3cm 的病变。患者接受两次间隔 30 天的 ALA-PDL-PDT 治疗。第二次治疗后 4-6 周，切除 isSCC 病变进行组织病理学评估。
17/20（85%）患者未发现残留的 isSCC。2 例有残留 isSCC 的患者有 skip 病变，这解释了治疗失败。排除有 skip 病变的患者，治疗后组织学清除率为 17/18（94%）。报告的副作用很小。
我们的研究受到样本量小和缺乏长期复发数据的限制。
ALA-PDL-PDT 方案是治疗面部 isSCC 的一种安全且耐受良好的治疗选择，可提供出色的美容和功能效果。
