title: A dose ranging study of photodynamic therapy with porfimer sodium (Photofrin) for treatment of basal cell carcinoma.
abstract: OBJECTIVE
  While basal cell carcinoma (BCC) is effectively treated by several methods, many patients with numerous or frequently occurring lesions seek alternatives that can treat multiple cancers, with improved cosmetic outcome. PDT for esophageal and lung carcinomas is approved at a porfimer sodium (Photofrin) dose of 2 mg/kg, but lower doses increase selectivity and decrease both cutaneous phototoxicity and cost. We evaluated low doses of porfimer sodium PDT for treatment of multiple BCC.
  
  
  METHODS
  Seventy-seven patients with 2,041 BCC were injected with 0.75, 0.875, or 1.0 mg/kg porfimer sodium and treated 2 days later with 630-nm light. Clinical responses were determined at 6 months, then periodically to 5 years.
  
  
  RESULTS
  Increasing porfimer sodium dose increased complete responses (CR), with initial CR rates of 72.7% (66-78%, 95% CI), 79.9% (73-86%, 95% CI), and 92.2% (91-93%, 95% CI), albeit with some lower selectivity at the highest dose. At 1 mg/kg, 5-year recurrence rates were 28% (21-35%, 95% CI) and 15% (11-18%, 95% CI) for sporadic and nevoid basal cell carcinoma syndrome (NBCCS) lesions, respectively.
  
  
  CONCLUSIONS
  This is the largest dose-ranging study of porfimer sodium, and the largest number of lesions treated in a single study. We found that with 1 mg/kg porfimer sodium, PDT can be a selective and durable treatment for sporadic and NBCCS-associated BCC.
authors.affiliation: Department of Dermatology, Roswell Park Cancer Institute, Buffalo, New York 14263, USA. allan.oseroff@roswellpark.org
authors.forename: Allan R
authors.initials: AR
authors.lastname: Oseroff
authors.forename: Leslie R
authors.initials: LR
authors.lastname: Blumenson
authors.forename: B Dale
authors.initials: BD
authors.lastname: Wilson
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Mang
authors.forename: David A
authors.initials: DA
authors.lastname: Bellnier
authors.forename: John C
authors.initials: JC
authors.lastname: Parsons
authors.forename: Noreen
authors.initials: N
authors.lastname: Frawley
authors.forename: Michele
authors.initials: M
authors.lastname: Cooper
authors.forename: Nathalie
authors.initials: N
authors.lastname: Zeitouni
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Dougherty
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000188:drug therapy*; D017323:Dihematoporphyrin Ether / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D012878:Skin Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents; D017323:Dihematoporphyrin Ether