Bazal hücreli karsinomda topikal fotodinamik tedavi
Küçük Resim Yok
Tarih
1999
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bazal hücreli karsinom (BCC), derinin en sık görülen malign tümörüdür. Fotodinamik tedavi (FTT), çeşitli solid tümörlerin tedavisi için yeni bir yöntem olup BCC tedavisinde de kullanılmıştır. Bu çalışmanın amacı BCC tedavisinde fotodinamik tedavinin etkinliğini belirlemekti. Çalışmaya 30 lezyon taşıyan toplam 26 hasta (13 yüz, 8 burun, 4 saçlı deri, 5 gövde lezyonu) dahil edildi. Klinik olarak lezyonların 14'ü yüzeyel ve 1&sı nodüler yapıya sahipti. Hastalara fotosensitizan olarak 5-aminolevünilik asit (ALA) krem tatbik edildi. ALA'nın 6-8 saatlik bekleme süresinden sonra inkoherent ışık kaynağı ile ışınlama yapıldı. Işınlama sırasında kırmızı ve kızılötesi ışık bandı (sırasıyla 580-720 nm ve 1250-1600 nm dalga boyunda) kullanıldı. Her lezyon 100-120 mw/crrf ışık şiddetinde ortalama 100 joule/crrf total doz aldı. Tedaviden önce ve tedaviden 2 ay sonra hem klinik hem de histopatolojik değerlendirme yapıldı. Tedavi sonrası 3 lezyondan biyopsi alınamadı ve söz konusu lezyonlar için sadece klinik değerlendirme yapıldı. Her hasta 2 aylık aralıklarla toplam 6 ay klinik takibe alındı. Klinik değerlendirmede tüm lezyonların % 56.6'sında tam cevap alınırken, histopatolojik olarak tam düzelme oranı % 62.9'du. Klinik olarak yüzeyel özelliğe sahip BCC lezyonları fotodinamik tedaviye oldukça iyi cevap verdi ve bu lezyonlarda klinik ve histopatolojik olarak % 92.8 tam cevap oranı elde edildi. Nodüler BCC lezyonlarında tam cevap oranı % 25 olarak belirlendi. Tedavi sırasında en yaygın yan etki, tolere edilebilen sıcaklık, kaşıntı ve ağrı hissi iken, tedavi sonrasında hafif ağrı, eritem ve ödem gözlendi. Sonuç olarak ALA krem ile fotodinamik tedavinin yüzeyel BCC tedavisinde etkili ve güvenli bir tedavi yöntemi olduğuna karar verildi.
Background and Design: Basal celi carcinoma is the most common malign tumour on the skin. Photodynamic treatment is a novel method for the treatment of a variety of solid tumours. İt has also been used for treatment of basal celi carcinoma. The purpose of this study was to determine the effectiveness of photodynamic treatment in the treatment of basal celi carcinoma. Material and methods: A total of 26 patients with 30 lesions (13 at the face, 8 on the nose, 4 on the scalp and finally 5 on the body) of basal cell carcinoma were included in this study. Clinically, of all the lesions, 14 lesions were superficial and 16 lesions had nodular pattern. Patients were administered topical 5-amino levulinic acid cream as photosensitizer agent. Six to eight hours after topical administration of 5-ALA, visible light irradiation was conducted with an incoherent light source. The combined red + infrared band was used during irradiation (respectively, 580-720 nm; 1250-1600 nm in wave length). Each lesion received a total dose of 100 J/cm2 at fluence rates of 100 to 120 mW/cm2. Histological and clinical evaluation were performed both before treatment and two months after treatment. Posttreatment examination were only clinically for three lesions, because second biopsy was unsuitable. İn addition, each of the patients was examined clinically at two months interval. The average clinical follow-up was 6 months. Results: İn clinical evaluation; complete response was achieved in 56.6% of lesions. Histologically, 62.9% of the specimens showed complete improvement rate. Clinically superficial BCC tumors were very responsive to PDTand the 14 superficial lesions treated shovved a 92.8% complete response rate both clinically and histologically. 25% complete response was achieved in patients with nodular BCC lesions. The most significant side effects after treatment were moderate pain, redness and edema. The most common adverse effect during treatment was tolerable heat, itching and pain sensation. Conclusions We can conclude that topical photodynamic therapy with ALA cream is a safe and effective modality in the treatment of superficial BCC.
Background and Design: Basal celi carcinoma is the most common malign tumour on the skin. Photodynamic treatment is a novel method for the treatment of a variety of solid tumours. İt has also been used for treatment of basal celi carcinoma. The purpose of this study was to determine the effectiveness of photodynamic treatment in the treatment of basal celi carcinoma. Material and methods: A total of 26 patients with 30 lesions (13 at the face, 8 on the nose, 4 on the scalp and finally 5 on the body) of basal cell carcinoma were included in this study. Clinically, of all the lesions, 14 lesions were superficial and 16 lesions had nodular pattern. Patients were administered topical 5-amino levulinic acid cream as photosensitizer agent. Six to eight hours after topical administration of 5-ALA, visible light irradiation was conducted with an incoherent light source. The combined red + infrared band was used during irradiation (respectively, 580-720 nm; 1250-1600 nm in wave length). Each lesion received a total dose of 100 J/cm2 at fluence rates of 100 to 120 mW/cm2. Histological and clinical evaluation were performed both before treatment and two months after treatment. Posttreatment examination were only clinically for three lesions, because second biopsy was unsuitable. İn addition, each of the patients was examined clinically at two months interval. The average clinical follow-up was 6 months. Results: İn clinical evaluation; complete response was achieved in 56.6% of lesions. Histologically, 62.9% of the specimens showed complete improvement rate. Clinically superficial BCC tumors were very responsive to PDTand the 14 superficial lesions treated shovved a 92.8% complete response rate both clinically and histologically. 25% complete response was achieved in patients with nodular BCC lesions. The most significant side effects after treatment were moderate pain, redness and edema. The most common adverse effect during treatment was tolerable heat, itching and pain sensation. Conclusions We can conclude that topical photodynamic therapy with ALA cream is a safe and effective modality in the treatment of superficial BCC.
Açıklama
Anahtar Kelimeler
Dermatoloji
Kaynak
Türkderm-Deri Hastalıkları ve Frengi Arşivi
WoS Q Değeri
Scopus Q Değeri
Cilt
33
Sayı
3