Service de dermatologie, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010 Paris, France, Dept of Dermatology, University of Dundee, Ninewells Hospital, Dundee, UK, Dept of Dermatology, Karolinska University Hospital Huddinge, Stockholm, Sweden, Dept of Dermatology, Karlskoga Hospital, Karlskoga, Sweden, Dept of Dermatology, Stirling Royal Infirmary, Stirling, UK, Dept of Dermatology, Ryhov County Hospital, Jönköping, Sweden, Dept of Dermatology, Brescia University Hospital, Brescia, Italy, Dept of Dermatology, University Hospital of Wales, Cardiff, UK, Dept of Dermatology, Leuven University Hospital, Leuven, Belgium, Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
This multicentre, randomized study compared photodynamic therapy using topical methyl aminolaevulinate (MAL PDT), a non-invasive modality, with cryotherapy for treatment of superficial basal cell carcinoma. Sixty patients with 114 lesions were treated with MAL cream (160 mg/g) applied for 3 hours before illumination (570-670 nm, light dose 75 J/cm) (1 session), and 58 with 105 lesions received cryotherapy (2 freeze-thaw cycles). Patients with an incomplete response at 3 months received 2 further MAL PDT sessions (n = 20) or repeat cryotherapy (n = 16). 100 lesions treated with MAL PDT and 93 lesions treated with cryotherapy were in complete response at 3 months after the last treatment and evaluable for recurrence over 5 years. There was no difference in 5-year recurrence rates with either treatment (20% with cryotherapy vs. 22% with MAL PDT, p = 0.86). However, more patients had an excellent cosmetic outcome with MAL PDT (60% vs. 16% with cryotherapy, p = 0.00078). These results provide support for the use of MAL PDT as a non-invasive, selective treatment alternative for primary superficial basal cell carcinoma.