Photodynamic therapy of virus-associated epithelial tumours of the face in organ transplant recipients.
OBJECTIVE
The benefit for organ recipients is still counteracted by the side effects of immunosuppression. Among other effects, there is a 50-250 times increased risk of developing malignant skin tumours. Because these malignomas are known to develop particularly aggressivly, there is a special need for an efficient therapy. Here we demonstrate the treatment response to aminolaevulinic acid (ALA)-based photodynamic therapy (PDT) in these patients.


METHODS
Five organ recipients with multiple tumours of the face were multifocally treated with ALA-PDT (32 tumours in all). After topical application of ALA using a thermogel, irradiation was done with a 635 nm diode laser (Ceralas 635, Biolitec, Jena, Germany). After intervals of 2 weeks, 4 weeks, and 12 weeks, therapeutic efficacy was assessed.


RESULTS
There was complete remission in 24 tumours (75%). In six tumours (18.8%) a second or third PDT session was necessary for complete clinical remission. In two tumours (5.6%, invasive squamous cell carcinomas) the lesions were refractory to PDT.


CONCLUSIONS
ALA-PDT is a valuable therapeutic alternative for the treatment of multifocal skin tumours in organ-transplanted patients. Furthermore, we see a growing role of ALA-PDT also for patients with frequently relapsing tumours of the skin with known genetically determined tumourigenesis (Gorlin-Goltz syndrome).
Schleier
Peter
P
Clinic of Maxillofacial Surgery/Plastic Surgery, Friedrich Schiller University, Bachstrasse 18, Jena, Germany. Peter.Schleier@med.uni-jena.de
Hyckel
Peter
P
Berndt
Alexander
A
Bode
Hans-Peter
HP
Albrecht
Volker
V
Hindermann
Winfried
W
Kosmehl
Hartwig
H
Zenk
Witold
W
Schumann
Dieter
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000627:therapeutic use*; D005153:Facial Neoplasms / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007642:Keratosis / Q000188:drug therapy / Q000821:virology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000821:virology; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012074:Remission Induction; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000821:virology; D019737:Transplants
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid