title: Photodynamic therapy vs. imiquimod 5% cream as skin cancer preventive strategies in patients with field changes: a randomized intraindividual comparison study.
abstract: BACKGROUND
  Actinic damage is responsible for the development of multiple, recurrent non-melanoma skin cancers (NMSCs), including actinic keratoses (AKs). Photodynamic therapy (PDT) and imiquimod cream (IMIQ) 5% are recommended as field-directed treatment options.
  
  
  OBJECTIVE
  To compare efficacy and safety of methyl aminolevulinate (MAL)-PDT vs. IMIQ 5% in the prevention of new NMSCs development patients with field changes.
  
  
  METHODS
  Patients with field cancerization of the face or scalp were randomized to receive MAL-PDT on one side, and IMIQ 5% on the mirror field. The primary endpoint was the number of new lesions on the treated fields during a 12-month follow-up period. Secondary assessments included adverse events and patient preference.
  
  
  RESULTS
  Forty-four patients completed the study. MAL-PDT and IMIQ did not differ concerning the primary endpoint, as there was no statistically significant difference in terms of development of new NMSCs at any point of follow-up. Both treatment regimens were safe and well tolerated. Patients' preference based on the procedure, response rates and future choice favoured MAL-PDT.
  
  
  CONCLUSIONS
  MAL-PDT and IMIQ 5% are safe and well-tolerated treatments that equally prevent development of new AKs in patients suffering from field changes. MAL-PDT treatment appears to be superior in terms of patients' preference.
authors.affiliation: First Dermatology Department, Medical Schoool, Aristotle University Thessaloniki, Thessaloniki, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Sotiriou
authors.affiliation: First Dermatology Department, Medical Schoool, Aristotle University Thessaloniki, Thessaloniki, Greece.
authors.forename: Z
authors.initials: Z
authors.lastname: Apalla
authors.affiliation: First Dermatology Department, Medical Schoool, Aristotle University Thessaloniki, Thessaloniki, Greece.
authors.forename: F
authors.initials: F
authors.lastname: Vrani
authors.affiliation: First Dermatology Department, Medical Schoool, Aristotle University Thessaloniki, Thessaloniki, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Lallas
authors.affiliation: First Dermatology Department, Medical Schoool, Aristotle University Thessaloniki, Thessaloniki, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Chovarda
authors.affiliation: First Dermatology Department, Medical Schoool, Aristotle University Thessaloniki, Thessaloniki, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Ioannides
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000287:Administration, Topical; D000368:Aged; D000634:Aminoquinolines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000077271:Imiquimod; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D012878:Skin Neoplasms / Q000517:prevention & control*
chemical_list: D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000077271:Imiquimod
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