Cairnduff F, Stringer M R, Hudson E J, Ash D V, Brown S B
Academic Unit of Radiotherapy, Cookridge Hospital, Leeds, UK.
Br J Cancer. 1994 Mar;69(3):605-8. doi: 10.1038/bjc.1994.112.
Between January 1991 and December 1992 a phase I trial of superficial photodynamic therapy (PDT) using topical application of 5-aminolaevulinic acid (ALA) was undertaken to treat Bowen's disease, superficial basal cell carcinomas (BCCs) and metastatic skin secondaries from breast (adenocarcinoma) or pinna (squamous cell carcinoma). Promising results were obtained with 36 areas of Bowen's disease, with a complete response rate of 89% at a median follow-up of 18 months. The treatment of BCCs was less successful, with 50% complete responses in 16 lesions at a median follow-up of 17 months. Metastatic nodules responded poorly. The treatment was well tolerated and discomfort during light irradiation could be reduced by prior application of 'Emla' cream. Lesions wept for 1-2 weeks following treatment and healed over a period of approximately 2 months. For large areas of Bowen's disease, particularly in anatomically difficult areas and in elderly patients, PDT using ALA may constitute a single simple alternative outpatient treatment to existing therapies. Further work is required to improve the results with BCCs.
1991年1月至1992年12月期间，开展了一项I期浅表光动力疗法（PDT）试验，采用局部应用5-氨基酮戊酸（ALA）治疗鲍恩病、浅表基底细胞癌（BCC）以及来自乳腺（腺癌）或耳廓（鳞状细胞癌）的转移性皮肤继发性肿瘤。对36处鲍恩病病灶进行治疗取得了良好效果，在中位随访18个月时完全缓解率为89%。BCC的治疗效果欠佳，16处病灶中有50%在中位随访17个月时达到完全缓解。转移性结节反应较差。该治疗耐受性良好，通过预先涂抹“复方利多卡因”乳膏可减轻光照期间的不适。治疗后病灶渗液1 - 2周，并在约2个月的时间内愈合。对于大面积的鲍恩病，尤其是在解剖结构复杂的区域以及老年患者中，使用ALA的PDT可能构成一种相对于现有疗法而言简单的门诊替代治疗方法。需要进一步开展工作以改善BCC的治疗效果。
