Efficacy and safety of topical ALA-PDT in the treatment of EMPD

Photodiagnosis Photodyn Ther. 2015 Mar;12(1):92-7. doi: 10.1016/j.pdpdt.2014.11.004. Epub 2014 Dec 3.

Abstract

Background: Photodynamic therapy (PDT) is a successful treatment for non-melanoma skin cancers in clinical practice. More and more doctors use PDT to cure the patients with skin cancer, especially in the elder. The purpose of this study was to evaluate the efficacy and safety of topical PDT using aminolevulinic acid (5-ALA) in the treatment of Extramammary Paget's disease (EMPD) and its role in surgical improvements.

Methods: A total of 38 cases were included in this study. Lesions were located in the scrotum and the penis. Thirty-one cases had surgical resection of the lesions followed by ALA-PDT (combination of PDT and surgery group). Seven cases received ALA-PDT without receiving surgical resection because the surgery is extremely difficult or the patients refused surgery (simple PDT group). Each tumor lesion was irradiated with 120J/cm(2) using a 635-nm laser for 15min. A total of 3 times of assisted ALA-PDT was applied after surgery.

Results: In the combination group, there was no recurrence in 6 months after treatment. In another group, recurrence occurred in 1 case in 6 months. All patients were able to complete the treatment protocol, with well cosmetic results and no moderate adverse reactions.

Conclusions: As an assistive therapy after tumor resection, ALA-PDT can reduce the excision range of the tumor lesions and will play more important role in the treatment of EMPD.

Keywords: Aminolevulinic acid; Extramammary Paget's disease (EMPD); Therapy; Topical photodynamic therapy.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Aged
  • Aged, 80 and over
  • Aminolevulinic Acid / administration & dosage*
  • Aminolevulinic Acid / adverse effects
  • Combined Modality Therapy / methods
  • Dermatologic Surgical Procedures*
  • Humans
  • Male
  • Middle Aged
  • Paget Disease, Extramammary / pathology
  • Paget Disease, Extramammary / therapy*
  • Radiation-Sensitizing Agents / administration & dosage
  • Radiation-Sensitizing Agents / adverse effects
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy*
  • Treatment Outcome

Substances

  • Radiation-Sensitizing Agents
  • Aminolevulinic Acid