Combined CO 2 laser and photodynamic therapy enhances the efficacy of treatment of basal cell carcinomas

In selected cases, conventional photodynamic therapy (C-PDT) is a valid alternative to surgery for the treatment of basal cell carcinoma (BCC). However, it is limited to superficial BCCs. Pretreatment of BCCs with ablative lasers may enhance its efficacy. We evaluated the C-PDT and CO laser combination therapy for the treatment of superficial and nodular BCCs. In this prospective, interventional, monocentric study, patients affected by BCC were treated with CO laser therapy, using a continuous superpulsed CO laser for nodular BCCs and a fractional CO laser for superficial BCCs. All patients were subsequently treated with photodynamic therapy using methyl aminolevulinate cream and an Aktilite CL128® (Galderma) lamp. 32 patients (20 males, 12 females) aged from 45 to 96 years (with a total of 181 BCCs) were treated using a CO laser combined with C-PDT. A 100 % cure rate was achieved at three months, with no signs of relapse in 97.2 % of the cases during the mean follow-up period (10.7 months, range 4 to 18 months). We observed mild adverse reactions and good aesthetic results. We recommend this combination therapy in selected cases, based on its high efficacy, good aesthetic results and few side effects.