Two-fold illumination in topical 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) for superficial basal cell carcinoma (sBCC): A retrospective case series and cohort study.

Abstract

There is limited literature on efficacy using a 2-fold illumination scheme in aminolevulinic acid (ALA) photodynamic therapy for superficial basal cell carcinoma (sBCC). We sought to determine the efficacy of ALA photodynamic therapy for sBCC using a 2-fold illumination scheme after a single ALA application. Treatment failure within 12 months posttreatment was assessed. In this retrospective case series and cohort study, electronic files from patients treated between January 2010 and August 2011 were reviewed. Follow-up data were gathered until March 2014. A total of 323 sBCC were analyzed for recurrence. Cumulative probability of clinical recurrence-free survival was 88.8% (95% confidence interval [CI] 85.4-92.4), 81.8% (95% CI 77.3-86.3), and 77.1% (95% CI 71.0-83.6) at 12, 24, and 48 months, respectively. For histologically confirmed recurrences this was 90.2% (95% CI 86.9-93.5), 85.4% (95% CI 75.5-89.3), and 81.8% (95% CI 75.5-88.1), respectively. A worse recurrence-free survival for tumors in the head and neck area and tumors larger than 10 mm was observed. The retrospective nature and the lack of a control group are limitations. ALA photodynamic therapy using a 2-fold illumination scheme might be a feasible treatment option with acceptable long-term results for small sBCC located outside the head and neck area.