6533b82afe1ef96bd128ba5e

RESEARCH PRODUCT

Hexyl aminolevulinate, 5‐aminolevulinic acid nanoemulsion and methyl aminolevulinate in photodynamic therapy of non‐aggressive basal cell carcinomas: A non‐sponsored, randomized, prospective and double‐blinded trial

Mari SalmivuoriMari GrönroosTaneli TaniLeevi AnnalaErna SnellmanJ.e. RäsänenNoora NeittaanmäkiIlkka Pölönen

subject

Skin Neoplasmsmedicine.medical_treatmentPhotodynamic therapyGastroenterologylaw.invention030207 dermatology & venereal diseases0302 clinical medicineMethyl aminolevulinateRandomized controlled trialnon-aggressive basal cell carcinomalawTOPICAL IMIQUIMODProspective Studies10. No inequalityProspective cohort studyPhotosensitizing AgentsSisätaudit - Internal medicinePAINkarsinoomat3. Good healthTreatment OutcomeInfectious Diseasesphotodynamic therapyTolerabilityFluorouracil030220 oncology & carcinogenesisBOWENS-DISEASEmedicine.symptommedicine.drugmedicine.medical_specialtyBiolääketieteet - Biomedicine3122 Cancersmethyl aminolevulinateEUROPEAN GUIDELINESDermatologySINGLE-BLINDLesion03 medical and health scienceshexyl aminolevulinatenon‐aggressive basal cell carcinomaSyöpätaudit - CancersInternal medicineparasitic diseasesMANAGEMENTmedicineCarcinomaHumansANESTHESIAbusiness.industryAminolevulinic Acidmedicine.disease5‐aminolevulinic acid nanoemulsionFLUOROURACILPROTOPORPHYRIN IX FORMATIONfotodynaaminen hoitoPhotochemotherapyCarcinoma Basal Cell5-aminolevulinic acid nanoemulsionbusinessSKIN

description

Background In the photodynamic therapy (PDT) of non‐aggressive basal cell carcinomas (BCCs), 5‐aminolevulinic acid nanoemulsion (BF‐200ALA) has shown non‐inferior efficacy when compared with methyl aminolevulinate (MAL), a widely used photosensitizer. Hexyl aminolevulinate (HAL) is an interesting alternative photosensitizer. To our knowledge, this is the first study using HAL‐PDT in the treatment of BCCs. Objectives To compare the histological clearance, tolerability (pain and post‐treatment reaction), and cosmetic outcome of MAL, BF‐200 ALA, and low‐concentration HAL in the PDT of non‐aggressive BCCs. Methods Ninety‐eight histologically verified non‐aggressive BCCs met the inclusion criteria, and 54 patients with 95 lesions completed the study. The lesions were randomized to receive LED‐PDT in two repeated treatments with MAL, BF‐200 ALA, or HAL. Efficacy was assessed both clinically and confirmed histologically at three months by blinded observers. Furthermore, cosmetic outcome, pain, post‐treatment reactions fluorescence, and photobleaching were evaluated. Results According to intention‐to‐treat analyses, the histologically confirmed lesion clearance was 93.8% (95% confidence interval [CI] = 79.9–98.3) for MAL, 90.9% (95% CI = 76.4–96.9) for BF‐200 ALA, and 87.9% (95% CI = 72.7–95.2) for HAL, with no differences between the arms (p=0.84). There were no differences between the arms as regards pain, post‐treatment reactions, or cosmetic outcome. Conclusions PDT with low‐concentration HAL and BF‐200 ALA have a similar efficacy, tolerability, and cosmetic outcome compared to MAL. HAL is an interesting new option in dermatological PDT, since good efficacy is achieved with a low concentration. peerReviewed

yearjournalcountryeditionlanguage
2020-01-01Journal of the European Academy of Dermatology and Venereology
https://doi.org/10.1111/jdv.16357