title: Aminolevulinic acid and methyl aminolevulinate equally effective in topical photodynamic therapy for non-melanoma skin cancers.
abstract: BACKGROUND
  Topical photodynamic therapy (PDT) is an effective treatment for superficial non-melanoma skin cancers. Two prodrugs, 5-aminolevulinic acid (ALA) and methyl aminolevulinate (MAL), are available for clinical use. There is, however, a lack of studies comparing the clinical effectiveness of these two prodrugs.
  
  
  OBJECTIVE
  The objective of the study was to compare the clinical response between ALA- and MAL-PDT when treating actinic keratosis (AK), Bowen's disease (BD), nodular basal cell carcinoma (nBCC) and superficial basal cell carcinoma (sBCC).
  
  
  METHODS
  During the period 2002-2009, patients with AK, BD, nBCC and sBCC were treated with ALA- and MAL-PDT at the Department of Dermatology at Karlskoga Hospital in Sweden using a fixed protocol. All patients were followed up approximately 6 months after treatment to evaluate the clinical results, which were analysed retrospectively.
  
  
  RESULTS
  In total, 116 patients with 203 tumours were treated with PDT during the study period. ALA- and MAL-PDT were used for 24 vs. 44 AK fields, 9 vs. 18 BD lesions, 19 vs. 25 nBCCs and 25 vs. 39 sBCCs. Response rates with ALA- and MAL-PDT, respectively, were 63% and 75% for AK, 89% and 78% for BD, 84% and 84% for nBCC and 88% and 87% for sBCC. There were no statistically significant differences in the complete clinical response rates for ALA- and MAL-PDT when used for any of the four lesion types.
  
  
  CONCLUSIONS
  ALA- and MAL-PDT appear to be equally effective in the treatment of AK, BD, nBCC and sBCC. Nevertheless, larger, prospective, randomized and controlled studies should be carried out to confirm these results.
authors: Department of Dermatology, Karlskoga Hospital, Karlskoga, Sweden.
authors: M
authors: M
authors: Tarstedt
authors: Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: M
authors: M
authors: Gillstedt
authors: Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: A-M
authors: AM
authors: Wennberg Larkö
authors: Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: J
authors: J
authors: Paoli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D002280:Basal Cell Carcinoma / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma; D008875:Middle Aged; D017319:Photosensitizing Agents / Q000627:therapeutic use; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid