Photodynamic therapy in combination with CO2 laser for the treatment of Bowen s disease

4^th International Conference on Photonics & Laser Technology

July 28-29, 2016 Berlin, Germany

Hong Cai

Air Force General Hospital, China

Posters & Accepted Abstracts: J Laser Opt Photonics

Abstract :

Background: Photodynamic therapy (PDT) involves the activation of a previously administered photosensitizing agent by visible light to induce tumor necrosis. Photosensitizers are topically applied in the treatment of skin tumors to avoid systemic side effects. Objectives: In this study, we evaluated the feasibility and efficacy of aminolevulinic acid (ALA) as a photosensitizer (ALAPDT) in combination with CO2 laser in the treatment of Bowen�s disease (BD; intra-epithelial squamous cell carcinoma). Methods: Twenty-two lesions from 18 patients were randomized into two groups: 11 lesions were treated with topical ALA-PDT (180 J/cm2 at 100 mW/cm2) + CO2 laser for 1-3 sessions. The remaining 11 lesions were treated with CO2 laser alone, serving as control group. All patients were reviewed at �1-week intervals. Biopsies were taken from BD lesions prior to treatment. The initial evaluation was undertaken 1 month after treatment and biopsies were harvested for histological evaluation. Patients who did not respond to the three sessions of treatment were referred to surgical treatment. Results: In the ALA-PDT+CO2 laser group, 72.73% (8/11) of BD lesions showed complete remission, with an overall clearance of 90.91%, and only one recurred (9%) during follow-up. Local side effects included mild erythema, edema, erosion and burning and/or stinging sensation. No systemic side effects were observed. In the control group, 63.63% (7/11) of lesions had complete remission, and the overall clearance was 54.55%. However, five lesions (45.45%) had recurrence. Local side effects included mild to moderate edema, erosion, ulceration, delayed healing, prolonged pain and scarring. There existed a significant difference in recurrence rate between the two groups (P<0.05). Moreover, after ALA-PDT plus CO2 laser treatment, complete necrosis was observed in responsive lesions, and 3 months later the atypical BD cells were replaced by normal keratinocytes. Conclusions: Topical ALA-PDT in combination with CO2 laser is safe, effective and is associated with low recurrence and reduced side effects.

Biography :

Email: ch1031@163.com