Comparison of the efficacy of ALA-PDT using an excimer-dye laser (630 nm) and a metal-halide lamp (600 to 740 nm) for treatment of Bowen's disease
Summary Background/Purpose Topical 5‐aminolevulinic acid‐based photodynamic therapy (ALA‐PDT) is an effective treatment for Bowen's disease (BD). In order to compare the efficacy of two different light sources, using either an excimer‐dye laser (EDL) (630 nm) or a metal‐halide lamp (MHL) (600 t...
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| Veröffentlicht in: | Photodermatology, photoimmunology & photomedicine photoimmunology & photomedicine, 2012-06, Vol.28 (3), p.142-146 |
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| creator | Mizutani, Kentaro Akita, Yoichi Yanagishita, Takeshi Kimura, Makoto Tanaka, Tohru Kinoshita, Yumi Nakano, Aki Tamada, Yasuhiko Matsumoto, Yoshinari Watanabe, Daisuke |
| description | Summary
Background/Purpose
Topical 5‐aminolevulinic acid‐based photodynamic therapy (ALA‐PDT) is an effective treatment for Bowen's disease (BD). In order to compare the efficacy of two different light sources, using either an excimer‐dye laser (EDL) (630 nm) or a metal‐halide lamp (MHL) (600 to 740 nm) a protocol for topical ALA‐PDT for treatment of BD of the extremities was established, and responses during 12 months follow‐up were assessed.
Methods
From 25 patients a total of 26 lesions that had been histopathologically diagnosed as BD from 2005 to 2010 in the Department of Dermatology at the Aichi Medical University Hospital were randomly selected. The light source used for the topical ALA‐PDT was EDL in 17 lesions and MHL in 9 lesions. The photosensitizing protoporphyrin IX that is produced within BD lesions 4 h after application of 20% ALA cream was mostly consumed after exposure to 100 J/cm2 irradiation using 630 nm EDL. Each lesion was irradiated once a week for 3 weeks, for a total dosage of 300 J/cm2 (100 mW/cm2). Patients were followed up clinically every 3 months for 12 months, and at 1 month after the final treatment lesions were evaluated histopathologically.
Results
Histologically, the complete response (CR) rate at 1‐month follow‐up was 82% (14/17 lesions) in the EDL treatment group and 100% (9/9 lesions) in the MHL treatment group (P > 0.05). The recurrence rate at 12 months after PDT was 46% (6/13 lesions, one patient lost to follow‐up) in the EDL group and 0% in the MHL group (P |
| doi_str_mv | 10.1111/j.1600-0781.2012.00658.x |
| format | Article |
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Background/Purpose
Topical 5‐aminolevulinic acid‐based photodynamic therapy (ALA‐PDT) is an effective treatment for Bowen's disease (BD). In order to compare the efficacy of two different light sources, using either an excimer‐dye laser (EDL) (630 nm) or a metal‐halide lamp (MHL) (600 to 740 nm) a protocol for topical ALA‐PDT for treatment of BD of the extremities was established, and responses during 12 months follow‐up were assessed.
Methods
From 25 patients a total of 26 lesions that had been histopathologically diagnosed as BD from 2005 to 2010 in the Department of Dermatology at the Aichi Medical University Hospital were randomly selected. The light source used for the topical ALA‐PDT was EDL in 17 lesions and MHL in 9 lesions. The photosensitizing protoporphyrin IX that is produced within BD lesions 4 h after application of 20% ALA cream was mostly consumed after exposure to 100 J/cm2 irradiation using 630 nm EDL. Each lesion was irradiated once a week for 3 weeks, for a total dosage of 300 J/cm2 (100 mW/cm2). Patients were followed up clinically every 3 months for 12 months, and at 1 month after the final treatment lesions were evaluated histopathologically.
Results
Histologically, the complete response (CR) rate at 1‐month follow‐up was 82% (14/17 lesions) in the EDL treatment group and 100% (9/9 lesions) in the MHL treatment group (P > 0.05). The recurrence rate at 12 months after PDT was 46% (6/13 lesions, one patient lost to follow‐up) in the EDL group and 0% in the MHL group (P < 0.05) (χ2 test with Fisher's exact test). The average period before recurrence after EDL treatment was 6.5 months.
Conclusion
A novel protocol for topical ALA‐PDT in Japanese in Asian patients with BD was developed and implemented. The protocol improved the CR rate compared with previous studies. Moreover, the present results indicate that the efficacy of topical ALA‐PDT using MHL was superior to that using EDL for BD patients.</description><identifier>ISSN: 0905-4383</identifier><identifier>EISSN: 1600-0781</identifier><identifier>DOI: 10.1111/j.1600-0781.2012.00658.x</identifier><identifier>PMID: 22548396</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>5-aminolevulinic acid ; Aged ; Aged, 80 and over ; Aminolevulinic Acid - administration & dosage ; Biological and medical sciences ; Bowen's disease ; Bowen's Disease - pathology ; Bowen's Disease - therapy ; clinical trial ; Dermatology ; Dyskeratosis ; Female ; Follow-Up Studies ; Humans ; Laser Therapy - instrumentation ; Laser Therapy - methods ; light source ; Male ; Medical sciences ; Middle Aged ; Photochemotherapy - instrumentation ; Photochemotherapy - methods ; photodynamic therapy ; Photosensitizing Agents - administration & dosage ; Tumors of the skin and soft tissue. Premalignant lesions</subject><ispartof>Photodermatology, photoimmunology & photomedicine, 2012-06, Vol.28 (3), p.142-146</ispartof><rights>2012 John Wiley & Sons A/S</rights><rights>2015 INIST-CNRS</rights><rights>2012 John Wiley & Sons A/S.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1600-0781.2012.00658.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1600-0781.2012.00658.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25887488$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22548396$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mizutani, Kentaro</creatorcontrib><creatorcontrib>Akita, Yoichi</creatorcontrib><creatorcontrib>Yanagishita, Takeshi</creatorcontrib><creatorcontrib>Kimura, Makoto</creatorcontrib><creatorcontrib>Tanaka, Tohru</creatorcontrib><creatorcontrib>Kinoshita, Yumi</creatorcontrib><creatorcontrib>Nakano, Aki</creatorcontrib><creatorcontrib>Tamada, Yasuhiko</creatorcontrib><creatorcontrib>Matsumoto, Yoshinari</creatorcontrib><creatorcontrib>Watanabe, Daisuke</creatorcontrib><title>Comparison of the efficacy of ALA-PDT using an excimer-dye laser (630 nm) and a metal-halide lamp (600 to 740 nm) for treatment of Bowen's disease</title><title>Photodermatology, photoimmunology & photomedicine</title><addtitle>Photodermatol. Photoimmunol. Photomed</addtitle><description>Summary
Background/Purpose
Topical 5‐aminolevulinic acid‐based photodynamic therapy (ALA‐PDT) is an effective treatment for Bowen's disease (BD). In order to compare the efficacy of two different light sources, using either an excimer‐dye laser (EDL) (630 nm) or a metal‐halide lamp (MHL) (600 to 740 nm) a protocol for topical ALA‐PDT for treatment of BD of the extremities was established, and responses during 12 months follow‐up were assessed.
Methods
From 25 patients a total of 26 lesions that had been histopathologically diagnosed as BD from 2005 to 2010 in the Department of Dermatology at the Aichi Medical University Hospital were randomly selected. The light source used for the topical ALA‐PDT was EDL in 17 lesions and MHL in 9 lesions. The photosensitizing protoporphyrin IX that is produced within BD lesions 4 h after application of 20% ALA cream was mostly consumed after exposure to 100 J/cm2 irradiation using 630 nm EDL. Each lesion was irradiated once a week for 3 weeks, for a total dosage of 300 J/cm2 (100 mW/cm2). Patients were followed up clinically every 3 months for 12 months, and at 1 month after the final treatment lesions were evaluated histopathologically.
Results
Histologically, the complete response (CR) rate at 1‐month follow‐up was 82% (14/17 lesions) in the EDL treatment group and 100% (9/9 lesions) in the MHL treatment group (P > 0.05). The recurrence rate at 12 months after PDT was 46% (6/13 lesions, one patient lost to follow‐up) in the EDL group and 0% in the MHL group (P < 0.05) (χ2 test with Fisher's exact test). The average period before recurrence after EDL treatment was 6.5 months.
Conclusion
A novel protocol for topical ALA‐PDT in Japanese in Asian patients with BD was developed and implemented. The protocol improved the CR rate compared with previous studies. Moreover, the present results indicate that the efficacy of topical ALA‐PDT using MHL was superior to that using EDL for BD patients.</description><subject>5-aminolevulinic acid</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aminolevulinic Acid - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Bowen's disease</subject><subject>Bowen's Disease - pathology</subject><subject>Bowen's Disease - therapy</subject><subject>clinical trial</subject><subject>Dermatology</subject><subject>Dyskeratosis</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Laser Therapy - instrumentation</subject><subject>Laser Therapy - methods</subject><subject>light source</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Photochemotherapy - instrumentation</subject><subject>Photochemotherapy - methods</subject><subject>photodynamic therapy</subject><subject>Photosensitizing Agents - administration & dosage</subject><subject>Tumors of the skin and soft tissue. Premalignant lesions</subject><issn>0905-4383</issn><issn>1600-0781</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkc1uEzEUhS0EoqHwCsgbRFlMuLbHHmfBIg3QIkUwSEVdWq7nDnWYn9SeqMmOLS_AA_IkeEgavLF973eO5XsIoQymLK23qylTABkUmk05MD4FUFJPt4_I5Nh4TCYwA5nlQosT8izGFQDkObCn5IRzmWsxUxPye9G3axt87Dva13S4RYp17Z11u_E-X86z8v0V3UTffae2o7h1vsWQVTukjY0Y6JkS8Ofnr659k_oVtbTFwTbZrW18NTLtOiEAdOhpkT-QdR_oENAOLXbD-NB5f4_d60grHzHZPidPattEfHHYT8m3jx-uFpfZ8svFp8V8mXkhhM4UqlzXCivJKslVzlnhnOQ8lZUoZMWF1PJG1ByQu1TBGXCutKwL5STymTglZ3vfdejvNhgH0_rosGlsh_0mGgZp3EWuC57Qlwd0c9NiZdbBtzbszMMsE_DqANjobFMH2zkf_3NS6-SkE_duz937BnfHPgMzZmtWZozQjBGaMVvzL1uzNeVlWaZT0md7vY8Dbo96G34YVaRfm-vPF-ar4Kq8FgtzLv4Cb_Gjpg</recordid><startdate>201206</startdate><enddate>201206</enddate><creator>Mizutani, Kentaro</creator><creator>Akita, Yoichi</creator><creator>Yanagishita, Takeshi</creator><creator>Kimura, Makoto</creator><creator>Tanaka, Tohru</creator><creator>Kinoshita, Yumi</creator><creator>Nakano, Aki</creator><creator>Tamada, Yasuhiko</creator><creator>Matsumoto, Yoshinari</creator><creator>Watanabe, Daisuke</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201206</creationdate><title>Comparison of the efficacy of ALA-PDT using an excimer-dye laser (630 nm) and a metal-halide lamp (600 to 740 nm) for treatment of Bowen's disease</title><author>Mizutani, Kentaro ; Akita, Yoichi ; Yanagishita, Takeshi ; Kimura, Makoto ; Tanaka, Tohru ; Kinoshita, Yumi ; Nakano, Aki ; Tamada, Yasuhiko ; Matsumoto, Yoshinari ; Watanabe, Daisuke</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-i3338-6e648f6ed51d5264217cc522e646375d23585b3f20e2c637e9022685f76c5e293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>5-aminolevulinic acid</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aminolevulinic Acid - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>Bowen's disease</topic><topic>Bowen's Disease - pathology</topic><topic>Bowen's Disease - therapy</topic><topic>clinical trial</topic><topic>Dermatology</topic><topic>Dyskeratosis</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Laser Therapy - instrumentation</topic><topic>Laser Therapy - methods</topic><topic>light source</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Photochemotherapy - instrumentation</topic><topic>Photochemotherapy - methods</topic><topic>photodynamic therapy</topic><topic>Photosensitizing Agents - administration & dosage</topic><topic>Tumors of the skin and soft tissue. Premalignant lesions</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mizutani, Kentaro</creatorcontrib><creatorcontrib>Akita, Yoichi</creatorcontrib><creatorcontrib>Yanagishita, Takeshi</creatorcontrib><creatorcontrib>Kimura, Makoto</creatorcontrib><creatorcontrib>Tanaka, Tohru</creatorcontrib><creatorcontrib>Kinoshita, Yumi</creatorcontrib><creatorcontrib>Nakano, Aki</creatorcontrib><creatorcontrib>Tamada, Yasuhiko</creatorcontrib><creatorcontrib>Matsumoto, Yoshinari</creatorcontrib><creatorcontrib>Watanabe, Daisuke</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Photodermatology, photoimmunology & photomedicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mizutani, Kentaro</au><au>Akita, Yoichi</au><au>Yanagishita, Takeshi</au><au>Kimura, Makoto</au><au>Tanaka, Tohru</au><au>Kinoshita, Yumi</au><au>Nakano, Aki</au><au>Tamada, Yasuhiko</au><au>Matsumoto, Yoshinari</au><au>Watanabe, Daisuke</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of the efficacy of ALA-PDT using an excimer-dye laser (630 nm) and a metal-halide lamp (600 to 740 nm) for treatment of Bowen's disease</atitle><jtitle>Photodermatology, photoimmunology & photomedicine</jtitle><addtitle>Photodermatol. Photoimmunol. Photomed</addtitle><date>2012-06</date><risdate>2012</risdate><volume>28</volume><issue>3</issue><spage>142</spage><epage>146</epage><pages>142-146</pages><issn>0905-4383</issn><eissn>1600-0781</eissn><abstract>Summary
Background/Purpose
Topical 5‐aminolevulinic acid‐based photodynamic therapy (ALA‐PDT) is an effective treatment for Bowen's disease (BD). In order to compare the efficacy of two different light sources, using either an excimer‐dye laser (EDL) (630 nm) or a metal‐halide lamp (MHL) (600 to 740 nm) a protocol for topical ALA‐PDT for treatment of BD of the extremities was established, and responses during 12 months follow‐up were assessed.
Methods
From 25 patients a total of 26 lesions that had been histopathologically diagnosed as BD from 2005 to 2010 in the Department of Dermatology at the Aichi Medical University Hospital were randomly selected. The light source used for the topical ALA‐PDT was EDL in 17 lesions and MHL in 9 lesions. The photosensitizing protoporphyrin IX that is produced within BD lesions 4 h after application of 20% ALA cream was mostly consumed after exposure to 100 J/cm2 irradiation using 630 nm EDL. Each lesion was irradiated once a week for 3 weeks, for a total dosage of 300 J/cm2 (100 mW/cm2). Patients were followed up clinically every 3 months for 12 months, and at 1 month after the final treatment lesions were evaluated histopathologically.
Results
Histologically, the complete response (CR) rate at 1‐month follow‐up was 82% (14/17 lesions) in the EDL treatment group and 100% (9/9 lesions) in the MHL treatment group (P > 0.05). The recurrence rate at 12 months after PDT was 46% (6/13 lesions, one patient lost to follow‐up) in the EDL group and 0% in the MHL group (P < 0.05) (χ2 test with Fisher's exact test). The average period before recurrence after EDL treatment was 6.5 months.
Conclusion
A novel protocol for topical ALA‐PDT in Japanese in Asian patients with BD was developed and implemented. The protocol improved the CR rate compared with previous studies. Moreover, the present results indicate that the efficacy of topical ALA‐PDT using MHL was superior to that using EDL for BD patients.</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><pmid>22548396</pmid><doi>10.1111/j.1600-0781.2012.00658.x</doi><tpages>5</tpages></addata></record> |
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| subjects | 5-aminolevulinic acid Aged Aged, 80 and over Aminolevulinic Acid - administration & dosage Biological and medical sciences Bowen's disease Bowen's Disease - pathology Bowen's Disease - therapy clinical trial Dermatology Dyskeratosis Female Follow-Up Studies Humans Laser Therapy - instrumentation Laser Therapy - methods light source Male Medical sciences Middle Aged Photochemotherapy - instrumentation Photochemotherapy - methods photodynamic therapy Photosensitizing Agents - administration & dosage Tumors of the skin and soft tissue. Premalignant lesions |
| title | Comparison of the efficacy of ALA-PDT using an excimer-dye laser (630 nm) and a metal-halide lamp (600 to 740 nm) for treatment of Bowen's disease |
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