title: Single treatment of low-risk basal cell carcinomas with pulsed dye laser-mediated photodynamic therapy (PDL-PDT) compared with photodynamic therapy (PDT): A controlled, investigator-blinded, intra-individual prospective study.
abstract: OBJECTIVE
  To compare a single treatment of PDL-PDT with PDT for BCCs in terms of efficacy, aesthetic outcome, and pain in patients with multiple BCCs.
  
  
  METHODS
  A prospective, controlled, intra-individual, investigator-blinded study was conducted on 15 patients with 62 BCCs. The BCCs on an individual patient were divided into two similarly-sized groups, and treated with PDT (630nm LED light source, fluence rate=30mW/cm2, total dose of 150J/cm2) and 585 nm-PDL-PDT (spot size=7mm, fluence=10J/cm2, pulse duration=10ms, 10% overlap, three passes, and cooling). Primary outcomes were complete BCC regression at months 3 and 12. Secondary outcomes were pain immediately after treatment, and aesthetic outcome evaluated by a blinded investigator.
  
  
  RESULTS
  No significant difference was found in the therapeutic effect between the two treatments (P=0.285). Complete regression of BCCs at 3-months follow-up occurred in 79% of the PDT treated area and 74% of the PDL-PDT area. At month 12, complete regression using PDT was 75% (95% confidence interval (CI) 0.55-0.89) compared to 59% (95% CI 0.41-0.75) for the PDL-PDT treated areas. Both treatments had low mean pain scores: 1.7 for PDT and 2.6 for PDL-PDT (P=0.049) and the aesthetic appearance was similar (P=0.763).
  
  
  CONCLUSIONS
  A single treatment with three passes of PDL-PDT is effective in clearing BCCs, but the recurrence rate is higher than in case of conventional PDT. PDL-PDT is associated with low treatment related pain, has similar cosmetic advantages as PDT but it requires less treatment time.
authors: Department of Dermatology, University Hospital Center Split, Split, Croatia; University of Split School of Medicine, Split, Croatia. Electronic address: acarija@kbsplit.hr.
authors: Antoanela
authors: A
authors: Čarija
authors: Department of Dermatology, University Hospital Center Split, Split, Croatia; University of Split School of Medicine, Split, Croatia.
authors: Neira
authors: N
authors: Puizina-Ivić
authors: Department of Dermatology, University Hospital Center Split, Split, Croatia.
authors: Dubravka
authors: D
authors: Vuković
authors: Department of Dermatology, University Hospital Center Split, Split, Croatia.
authors: Lina
authors: L
authors: Mirić Kovačević
authors: University of Split School of Medicine, Split, Croatia.
authors: Vesna
authors: V
authors: Čapkun
mesh_terms: D000368:Aged; D000072716:Cancer Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D054025:Lasers, Dye / Q000009:adverse effects / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use; D016037:Single-Blind Method; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D011838:Radiation-Sensitizing Agents
keywords: ALA-photodynamic therapy; BCC; Non-melanoma skin cancers; PDL; Pulsed-dye laser-mediated photodynamic therapy