Methylaminolaevulinate-based photodynamic therapy of Bowen's disease and squamous cell carcinoma

P. G. Calzavara-Pinton, M. Venturini, R. Sala, R. Capezzera, G. Parrinello, C. Specchia, C. Zane

Research output: Contribution to journalArticle

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Abstract

Background: Photodynamic therapy (PDT) with methylaminolaevulinate (MAL) is an approved noninvasive treatment option for actinic keratosis and Bowen's disease (BD), two precursors of invasive squamous cell carcinoma (SCC). Objectives: To assess efficacy, prognostic features, tolerability and cosmetic outcome of MAL-PDT for the treatment of BD and SCC. Methods: In total, 112 biopsy-proven lesions of BD and SCC in 55 subjects were treated in an outpatient setting. MAL cream (160 mg g-1) was applied for 3 h prior to illumination with a light-emitting diode source (wavelength range 635 ± 18 nm; light dose 37 J cm-2). A second MAL-PDT session was given 7 days later. Complete response rate at 3 months after the last treatment, recurrence rate at the 24-month follow-up, and cosmetic outcome were recorded. Results: The overall complete response rates were 73.2% at 3 months and 53.6% at 2 years. Clinical thickness, atypia and lesion depth were significant predictors of the response at 3 months when using a univariate analysis (P <0.001). A multivariate logistic regression model, with robust variance estimation, showed that cell atypia was the only statistically significant independent predictor of the treatment outcome at 3 months. Conclusions: MAL-PDT may represent a valuable, effective and well tolerated treatment option with good cosmetic outcome for superficial, well-differentiated (Broders' scores I and II) BD and microinvasive SCC. In contrast, its use for superficial SCCs with a microinvasive histological pattern and for nodular, invasive lesions, particularly if poorly differentiated keratinocytes are present (Broders' scores III and IV), should be avoided.

Original languageEnglish
Pages (from-to)137-144
Number of pages8
JournalBritish Journal of Dermatology
Volume159
Issue number1
DOIs
Publication statusPublished - Jul 2008

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Bowen's Disease
Photochemotherapy
Squamous Cell Carcinoma
Cosmetics
Logistic Models
Actinic Keratosis
Light
Therapeutics
Lighting
Keratinocytes
Outpatients
Biopsy
Recurrence

Keywords

  • Bowen's disease
  • Clinical trial
  • Cosmetic outcome
  • Photodynamic therapy
  • Squamous cell carcinoma
  • Topical methylaminolaevulinate

ASJC Scopus subject areas

  • Dermatology

Cite this

Calzavara-Pinton, P. G., Venturini, M., Sala, R., Capezzera, R., Parrinello, G., Specchia, C., & Zane, C. (2008). Methylaminolaevulinate-based photodynamic therapy of Bowen's disease and squamous cell carcinoma. British Journal of Dermatology, 159(1), 137-144. https://doi.org/10.1111/j.1365-2133.2008.08593.x

Methylaminolaevulinate-based photodynamic therapy of Bowen's disease and squamous cell carcinoma. / Calzavara-Pinton, P. G.; Venturini, M.; Sala, R.; Capezzera, R.; Parrinello, G.; Specchia, C.; Zane, C.

In: British Journal of Dermatology, Vol. 159, No. 1, 07.2008, p. 137-144.

Research output: Contribution to journalArticle

Calzavara-Pinton, PG, Venturini, M, Sala, R, Capezzera, R, Parrinello, G, Specchia, C & Zane, C 2008, 'Methylaminolaevulinate-based photodynamic therapy of Bowen's disease and squamous cell carcinoma', British Journal of Dermatology, vol. 159, no. 1, pp. 137-144. https://doi.org/10.1111/j.1365-2133.2008.08593.x
Calzavara-Pinton PG, Venturini M, Sala R, Capezzera R, Parrinello G, Specchia C et al. Methylaminolaevulinate-based photodynamic therapy of Bowen's disease and squamous cell carcinoma. British Journal of Dermatology. 2008 Jul;159(1):137-144. https://doi.org/10.1111/j.1365-2133.2008.08593.x
Calzavara-Pinton, P. G. ; Venturini, M. ; Sala, R. ; Capezzera, R. ; Parrinello, G. ; Specchia, C. ; Zane, C. / Methylaminolaevulinate-based photodynamic therapy of Bowen's disease and squamous cell carcinoma. In: British Journal of Dermatology. 2008 ; Vol. 159, No. 1. pp. 137-144.
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abstract = "Background: Photodynamic therapy (PDT) with methylaminolaevulinate (MAL) is an approved noninvasive treatment option for actinic keratosis and Bowen's disease (BD), two precursors of invasive squamous cell carcinoma (SCC). Objectives: To assess efficacy, prognostic features, tolerability and cosmetic outcome of MAL-PDT for the treatment of BD and SCC. Methods: In total, 112 biopsy-proven lesions of BD and SCC in 55 subjects were treated in an outpatient setting. MAL cream (160 mg g-1) was applied for 3 h prior to illumination with a light-emitting diode source (wavelength range 635 ± 18 nm; light dose 37 J cm-2). A second MAL-PDT session was given 7 days later. Complete response rate at 3 months after the last treatment, recurrence rate at the 24-month follow-up, and cosmetic outcome were recorded. Results: The overall complete response rates were 73.2{\%} at 3 months and 53.6{\%} at 2 years. Clinical thickness, atypia and lesion depth were significant predictors of the response at 3 months when using a univariate analysis (P <0.001). A multivariate logistic regression model, with robust variance estimation, showed that cell atypia was the only statistically significant independent predictor of the treatment outcome at 3 months. Conclusions: MAL-PDT may represent a valuable, effective and well tolerated treatment option with good cosmetic outcome for superficial, well-differentiated (Broders' scores I and II) BD and microinvasive SCC. In contrast, its use for superficial SCCs with a microinvasive histological pattern and for nodular, invasive lesions, particularly if poorly differentiated keratinocytes are present (Broders' scores III and IV), should be avoided.",
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AU - Parrinello, G.

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