Photodynamic Therapy with Methyl Aminolevulinate for Nodular Basal Cell Carcinoma

Song, Ki Hoon; Hong, Jin Woo; Kim, Ki Ho

Abstract

BACKGROUND
Photodynamic therapy (PDT) is useful for treating basal cell carcinoma (BCC), and the incidence of nodular type BCC is high among Koreans. However, only one case on the treatment of nodular BCC using methyl aminolevulinate (MAL)-PDT has been reported in Korea.
OBJECTIVE
We investigated the efficacy and tolerability of PDT for treating nodular BCC in Korean patients.
METHODS
Fifteen patients with nodular BCC were treated. We conducted three MAL-PDT sessions separated by a 1 week interval and assessed the clinical therapeutic effects after 3 months. Then, we performed a histopathological assessment of the lesions in patients who showed complete clinical responses (CR) and surgical procedures for lesions in patients who showed no clinical response (NR). We prescribed three more MAL-PDT sessions to the patients who showed partial clinical responses (PR), and decided whether to carry out a histopathological evaluation or to treat with surgery according to the clinical therapeutic assessment after 3 months.
RESULTS
After the first three MAL-PDT sessions, three patients showed CR, eight patients showed PR, and four patients showed NR. One of the eight patients, who had been treated repeatedly, showed CR.
CONCLUSION
BCC occurs mainly as the nodular type in Korea, so MAL-PDT may be the main treatment for BCC in Korean patients. However, it could be used as an alternative treatment for selected nodular BCCs when it is difficult to use conventional therapy or when a serious cosmetic defect is expected.