title: Experience and BCC subtypes as determinants of MAL-PDT response: preliminary results of a national Brazilian project.
abstract: Non-melanoma skin cancer is the most prevalent cancer type in Brazil and worldwide. Photodynamic therapy (PDT) is a noninvasive technique with excellent cosmetic outcome and good curative results, when used for the initial stages of skin cancer. A Brazilian program was established to determine the efficacy of methyl aminolevulinate (MAL)-PDT, using Brazilian device and drug. The equipment is a dual device that combines the photodiagnosis, based on widefield fluorescence, and the treatment at 630nm. A protocol was defined for the treatment of basal cell carcinoma with 20% MAL cream application. The program also involves the training of the medical teams at different Brazilian regions, and with distinct facilities and previous PDT education. In this report we present the partial results of 27 centers with 366 treated BCC lesions in 294 patients. A complete response (CR) was observed in 76.5% (280/366). The better response was observed for superficial BCC, with CR 160 lesions (80.4%), when compared with nodular or pigmented BCC. Experienced centers presented CR of 85.8% and 90.6% for superficial and nodular BCC respectively. A high influence of the previous doctor experience on the CR values was observed, especially due to a better tumor selection.
authors.affiliation: Biophotonics Laboratory, São Carlos Institute of Physics, University of São Paulo (USP), 13566-590 São Carlos, São Paulo, Brazil. Electronic address: dorapatriciaramirez@gmail.com.
authors.forename: Dora P
authors.initials: DP
authors.lastname: Ramirez
authors.affiliation: Biophotonics Laboratory, São Carlos Institute of Physics, University of São Paulo (USP), 13566-590 São Carlos, São Paulo, Brazil.
authors.forename: Cristina
authors.initials: C
authors.lastname: Kurachi
authors.affiliation: Biophotonics Laboratory, São Carlos Institute of Physics, University of São Paulo (USP), 13566-590 São Carlos, São Paulo, Brazil.
authors.forename: Natalia M
authors.initials: NM
authors.lastname: Inada
authors.affiliation: Biophotonics Laboratory, São Carlos Institute of Physics, University of São Paulo (USP), 13566-590 São Carlos, São Paulo, Brazil.
authors.forename: Lilian T
authors.initials: LT
authors.lastname: Moriyama
authors.affiliation: Skin Department, Amaral Carvalho Foundation, Brazil.
authors.forename: Ana G
authors.initials: AG
authors.lastname: Salvio
authors.affiliation: Biophotonics Laboratory, São Carlos Institute of Physics, University of São Paulo (USP), 13566-590 São Carlos, São Paulo, Brazil.
authors.forename: José D
authors.initials: JD
authors.lastname: Vollet Filho
authors.affiliation: Biophotonics Laboratory, São Carlos Institute of Physics, University of São Paulo (USP), 13566-590 São Carlos, São Paulo, Brazil.
authors.forename: Layla
authors.initials: L
authors.lastname: Pires
authors.affiliation: Biophotonics Laboratory, São Carlos Institute of Physics, University of São Paulo (USP), 13566-590 São Carlos, São Paulo, Brazil.
authors.forename: Hilde H
authors.initials: HH
authors.lastname: Buzzá
authors.affiliation: Biophotonics Laboratory, São Carlos Institute of Physics, University of São Paulo (USP), 13566-590 São Carlos, São Paulo, Brazil.
authors.forename: Cintia Teles
authors.initials: CT
authors.lastname: de Andrade
authors.affiliation: Biophotonics Laboratory, São Carlos Institute of Physics, University of São Paulo (USP), 13566-590 São Carlos, São Paulo, Brazil.
authors.forename: Clovis
authors.initials: C
authors.lastname: Greco
authors.affiliation: Biophotonics Laboratory, São Carlos Institute of Physics, University of São Paulo (USP), 13566-590 São Carlos, São Paulo, Brazil.
authors.forename: Vanderlei S
authors.initials: VS
authors.lastname: Bagnato
mesh_terms: D000622:Aminolevulinic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001938:Brazil; D002280:Basal Cell Carcinoma / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid
keywords: BCC subtypes; Determinants; Doctor experience; National Brazilian project; Non-melanoma skin cancer; Photodynamic therapy