Photodynamic therapy of multiple nonmelanoma skin cancers with verteporfin and red light-emitting diodes - Two-year results evaluating tumor response and cosmetic outcomes

被引:79
作者
Lui, H
Hobbs, L
Tope, WD
Lee, PK
Elmets, C
Provost, N
Chan, A
Neyndorff, H
Su, XY
Jain, H
Hamzavi, I
McLean, D
Bissonnette, R
机构
[1] Univ British Columbia, Div Dermatol, Vancouver, BC V5Z 4E8, Canada
[2] Vancouver Gen Hosp, Vancouver, BC, Canada
[3] Univ Minnesota, Dept Dermatol, Minneapolis, MN 55455 USA
[4] Univ Alabama, Dept Dermatol, Birmingham, AL 35294 USA
[5] Univ Montreal Hosp Ctr, Div Dermatol, Montreal, PQ, Canada
[6] QLT Inc, Vancouver, BC, Canada
关键词
D O I
10.1001/archderm.140.1.26
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background: Efficient treatment of patients with multiple synchronous nonmelanoma skin cancers represents a therapeutic challenge. Objective: To study the safety and efficacy of photodynamic therapy (PDT) with verteporfin and red light in the treatment of multiple nonmelanoma skin cancers. Design: Open-label, randomized, multicenter, dose-ranging phase 2 study conducted at 4 North American university-based dermatology clinics. Patients: Fifty-four patients with 421 multiple nonmelanoma skin cancers including superficial and nodular basal cell carcinoma and squamous cell carcinoma in situ (Bowen disease). Methods: A single intravenous infusion of 14 mg/m(2) of verteporfin followed I to 3 hours later by exposure of tumors to 60,120, or 180 J/cm(2) of red light (688 +/- 10 nm) from a light-emitting diode panel. Main Outcome Measures: Pathologic response of treated sites was assessed at 6 months. Clinical and cosmetic responses were assessed and graded at 6 weeks, 3 months, and 6 months after verteporfin PDT, with optional follow-up visits at 12, 18, and 24 months. Results: The histopathologic response, defined as absence of tumor on biopsy specimens 6 months after verteporfin PDT, ranged from 69% at 60 J/cm(2) to 93% at 180 J/cm(2). At 24 months of follow-up (276 tumors in 31 patients), the clinical complete response rate ranged from 51% at 60 J/cm(2) to 95% at 180 J/cm(2). No significant systemic adverse events were observed; most events occurred at the treated tumor sites and included events such as pain. Overall, 65% (95% confidence interval, 58%-71%) of tumors were judged to have good to excellent cosmesis at 24 months. Conclusion: A single course of verteporfin PDT showed treatment benefit for patients with multiple nonmelanoma skin cancers.
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页码:26 / 32
页数:7
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