光动力疗法治疗基底细胞癌:优势,缺点,与手术方式的比较,以及作为辅助治疗的潜在作用。

IF 8.6 1区 医学 Q1 DERMATOLOGY American Journal of Clinical Dermatology Pub Date : 2023-12-02 DOI:10.1007/s40257-023-00829-w
Maggie Chen, Albert Zhou, Amor Khachemoune
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引用次数: 0

摘要

基底细胞癌(BCC)是最常见的皮肤癌,有多种治疗选择,包括金标准莫氏显微手术(MMS)、手术切除、电干燥刮除、放射治疗、冷冻手术和光动力治疗(PDT)。虽然PDT目前被批准用于治疗光化性角化病,但它已被适应症外用于治疗可能无法耐受手术或其他治疗方式的BCC患者。我们对这些模式的疗效进行了回顾,并描述了影响PDT和MMS使用的重要因素。ALA-PDT和MAL-PDT都是低风险BCC的有效治疗选择,可以作为手术切除的非侵入性替代方案,对于不适合接受手术的患者具有良好的美容效果。特别是,PDT可能被认为是预防和治疗某些遗传综合征(如Gorlin综合征)患者的BCC病变的辅助手段,并与出现在某些部位的病变的手术切除相结合。PDT的局限性包括缺乏防止复发的边缘控制、疼痛和某些光敏剂的成本。未来的研究应探讨PDT作为辅助治疗的作用,方案的标准化,以及PDT治疗后复发的原因和方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Photodynamic Therapy in Treating a Subset of Basal Cell Carcinoma: Strengths, Shortcomings, Comparisons with Surgical Modalities, and Potential Role as Adjunctive Therapy

Basal cell carcinoma (BCC) is the most common skin cancer, for which there are multiple treatment options, including the gold standard Mohs micrographic surgery (MMS), surgical excision, electrodesiccation and curettage, radiation therapy, cryosurgery, and photodynamic therapy (PDT). While PDT is currently approved for treating actinic keratosis, it has been used off-label to treat BCC patients who may not tolerate surgery or other treatment modalities. We present a review of the efficacy of these modalities and describe important considerations that affect the usage of PDT and MMS. ALA-PDT and MAL-PDT are both efficacious treatment options for lower-risk BCC that can serve as non-invasive alternatives to surgical excision with favorable cosmetic outcomes in patients unsuitable to undergo surgery. In particular, PDT may be considered an adjuvant for the prevention and treatment of BCC lesions in patients with some genetic syndromes such as Gorlin syndrome, and in combination with surgical excision in lesions presenting in certain locations. Limitations to PDT include lack of margin control to prevent recurrence, pain, and cost of certain photosensitizers. Future studies should investigate the role of PDT as adjunctive therapy, standardization of protocols, and causes and ways to address recurrence following PDT treatment.

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来源期刊
CiteScore
15.20
自引率
2.70%
发文量
84
审稿时长
>12 weeks
期刊介绍: The American Journal of Clinical Dermatology is dedicated to evidence-based therapy and effective patient management in dermatology. It publishes critical review articles and clinically focused original research covering comprehensive aspects of dermatological conditions. The journal enhances visibility and educational value through features like Key Points summaries, plain language summaries, and various digital elements, ensuring accessibility and depth for a diverse readership.
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