Similar effectiveness of methyl aminolevulinate and 5-aminolevulinate in topical photodynamic therapy for nodular basal cell carcinoma.
BACKGROUND
Photodynamic therapy (PDT) for basal cell carcinoma (BCC) is a treatment modality that is increasingly used in dermato-oncology. Currently, 2 topical photosensitizers, 5-aminolevulinate (ALA) and methyl aminolevulinate (MAL) are widely used, but their efficacy in BCC has not yet been compared in a clinical setting.


OBJECTIVE
To evaluate the effect, degree of pain, and costs of ALA-PDT versus MAL-PDT in nodular BCC (nBCC).


METHODS
Patients suffering from BCC were randomly assigned to either ALA-PDT (n=22) or MAL-PDT (n=21) in a pilot study. In each group, half of the tumors were debulked prior to PDT. Eight weeks after treatment, the therapeutic outcome was checked histologically. Pain scores were assessed using a visual analogue scale.


RESULTS
Residual tumor tissue was detected in 6 BCCs of each study group. No significant difference between ALA-PDT and MAL-PDT was found with regard to therapeutic efficacy and pain scores. Of note, however, the costs of MAL-PDT were 6-fold higher than those of ALA-PDT.


CONCLUSIONS
In this study we did not observe any differences in short-term efficacy between ALA-PDT and MAL-PDT. Therefore, both ALA and MAL can be equally recommended as topical photosensitizers in PDT.
Kuijpers
Daniëlle I
DI
Department of Dermatology, University Hospital Maastricht, Maastricht, The Netherlands. dku@sder.azm.nl
Thissen
Monique R
MR
Thissen
Carleine A
CA
Neumann
Martino H
MH
D000287:Administration, Topical; D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D002280:Basal Cell Carcinoma / Q000188:drug therapy*; D006801:Humans; D010147:Pain Measurement; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D010865:Pilot Projects; D012878:Skin Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid