title: Using photodynamic therapy as a neoadjuvant treatment in the surgical excision of nonmelanotic skin cancers: prospective study.
abstract: BACKGROUND
  Topical photodynamic therapy (PDT) is a successful treatment for nonmelanotic skin cancers (NMSCs). Nevertheless, surgical excision continues to be the gold standard treatment. Cervicofacial excision often results in functional and aesthetic impairment. We hypothesize that topical PDT as a neoadjuvant therapy to surgical excision may reduce tumour size and subsequently decrease local morbidity.
  
  
  OBJECTIVE
  To determine the utility of PDT in reducing the NMSC area for the purpose of surgical excision.
  
  
  METHODS
  A prospective cohort study.
  
  
  RESULTS
  Thirty-three basal cell carcinomas with a mean area of 523.11 ± 120.93 mm² and 26 squamous cell carcinomas with a mean area of 357.53 ± 61.96 mm² were included. Of these lesions, 22 demonstrated a complete curative response after an average of two PDT treatments, which were then confirmed with histologically negative biopsies. The remaining lesions demonstrated a partial response to topical PDT with a maximum reduction in lesion area following an average of three PDT treatments of at least 88% (p < .05). These lesions were then excised with clear histologic margins. Follow-up at 1 year for all lesions demonstrated no locoregional recurrence.
  
  
  CONCLUSIONS
  This is the first study to investigate the efficacy of neoadjuvant topical PDT in the management of NMSC. The results suggest that for NMSC not demonstrating a complete curative response to PDT, neoadjuvant PDT can substantially reduce tumour burden, allowing for less morbid surgical excisions with histologically clear margins.
authors: Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON.
authors: Goran
authors: G
authors: Jeremic
authors: Michael G
authors: MG
authors: Brandt
authors: Kevin
authors: K
authors: Jordan
authors: Philip C
authors: PC
authors: Doyle
authors: Edward
authors: E
authors: Yu
authors: Corey C
authors: CC
authors: Moore
mesh_terms: D000287:Administration, Topical; D000368:Aged; D001706:Biopsy; D002280:Basal Cell Carcinoma / Q000188:drug therapy / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005153:Facial Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy / Q000379:methods; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D011446:Prospective Studies; D012535:Scalp; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents