Photodynamic Therapy Using 5-aminolaevulinic Acid In The Treatment Of Basal Cell Carcinomas:Clinical Evaluation Of 16 Patients

Objective:To assess the e fficacy and safety of Photodynamic therapy(PDT)using 5-aminolaevulinic acid(ALA) in the treatment of Basal cell carcinomas.Methods:16 patients with 16 Basal Cell Carcinomas lesions were treated with Photodynamic therapy using 5-aminolaevulinic acid, including 10 males and 6females, at the age of 41-91 years,with course of 1-7 years,area of lesions of 0.3-5cm2.12 lesions less than 1 cm in diameter(small lesions group), 4 lesions greater than 1 cm in diameter(large lesion group).All these 16 patients were diagnosed with Basal Cell Carcinomas by pathologic examination before treatment.In accordance with the infiltration degree of tumor cells and the expected PDT penetration depth,according to the thickness of lesions,the disease is divided into mild to moderate(group I,below 2 mm)and severe(group II,over 2 mm).the number of group I skin lesions is 13,and.the number of group II skin lesions is 3.All lesions were treated topically with 20%ALA solution for 3h, then were exposed to red light of 630 nm,80J/ cm2.Determine the efficacy with the standard enacted by the Chinese laser hematoporphyrin meeting :complete remission(CR) for lesions disappeared altogether. Significant remission(SR): for more than 50% of the tumor tissue disappeared. Minor remission(MR):for less than 50% tumor regression. No remission(NR): no change or deterioration.Determine the efficacy after 5 times treatment.Result:After theatment for 5 times,16 Basal cell carcinomas lesions showed CR 11(68.75%),SR 2(12.5%),MR 3(18.75%).In small lesions group,CR11(91.7%),SR 1(8.3%).In large lesion group,SR 1(25%),MR 3(75%).In m ild to moderate lesions group(group I),CR 11(84.6%),SR 2(15.4%).In severe group(group II),MR 3(100%).After 5 times of treatment,the cure rate of small lesions group is better than that of large lesions group(5times:P<0.01).The cure rate of m ild to moderate lesions group(group I) is better than that of severe group(group II)(P<0.01). 11 lesions(68.75%) with burning sensation in the course of treatment,can be tolerated.6 lesions(37.5%) lesions with varying degrees of edema, not given special treatment,lasting 2-5 days to subside on their own.No blisters, erosions and scars.Healed patients were followed for 6-12 months.No recurrence occured.Conclusion:Photodynamic therapy using 5-aminolaevulinic acid in the treatment of Basal Cell Carcinomas is efficacy.Adverse reactions were mild.The differences of efficacy is related to the lesion area and the lesion thickness(histological severity).