title: Long-term outcomes following Foscan®-PDT of basal cell carcinomas.
abstract: OBJECTIVE
  In a previous publication we showed that mTHPC-PDT (Foscan®-PDT) is an effective treatment of basal cell carcinomas (BCCs) in "difficult to treat" locations and presented optimized treatment parameters to reduce costs and side effects. Now we present long-term results of the same study population.
  
  
  METHODS
  Following PDT of a total of 460 BCCs in 117 subjects, the patients/lesions were followed-up for a mean duration of 42 (range: 2-72) months. Two patients dropped out of follow-up; 13 patients died of unrelated causes. Recurrences were treated either by repeated PDT or other established methods.
  
  
  RESULTS
  The sustained clearance rate was 93.7% and the overall treatment success rate was 90.7%. Kaplan-Meier analysis revealed an estimated recurrence free fraction of patients at 5 years of 95.1%, 92.4%, 85.1%, and 74.0% for the four different photosensitizer dose groups (0.06-0.15, 0.05, 0.04, and 0.03 mg/kg). High-risk lesions (recurrences, thickness >3 mm) recurred more often than low-risk ones, and recurrences mostly (>50%) occurred during the first year of follow-up.
  
  
  CONCLUSIONS
  Long-term outcomes of high-dose (0.06-0.15 mg/kg) and reduced-dose (0.05 mg/kg) Foscan®-PDT in "difficult to treat" BCCs compare favorably with other methods, even in high-risk lesions (recurrent and/or thick lesions). A recommended combination of treatment parameters for low-dose therapy seems to be: 0.05 mg/kg Foscan®, 24 hours drug-light interval (DLI), fluence ≥40 J/cm(2) . Prospective randomized studies are needed to look into low-dose mTHPC-PDT of BCCs in more detail and to directly compare it with other treatments.
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery, Klinikum Grosshadern at the Ludwig Maximilian University, Marchioninistr. 15, 81377 Munich, Germany. christian.betz@med.uni-muenchen.de
authors.forename: Christian S
authors.initials: CS
authors.lastname: Betz
authors.forename: Winrich
authors.initials: W
authors.lastname: Rauschning
authors.forename: Evgueni Ph
authors.initials: EP
authors.lastname: Stranadko
authors.forename: Mikhail V
authors.initials: MV
authors.lastname: Riabov
authors.forename: Valery N
authors.initials: VN
authors.lastname: Volgin
authors.forename: Volker
authors.initials: V
authors.lastname: Albrecht
authors.forename: Nikolay E
authors.initials: NE
authors.lastname: Nifantiev
authors.forename: Colin
authors.initials: C
authors.lastname: Hopper
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000188:drug therapy* / Q000401:mortality; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D054023:Lasers, Semiconductor; D008297:Male; D008652:Mesoporphyrins / Q000627:therapeutic use*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D008652:Mesoporphyrins; D017319:Photosensitizing Agents; C072269:temoporfin