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首页> 外文期刊>British Journal of Dermatology >Fractionated 5-aminolaevulinic acid-photodynamic therapy vs. surgical excision in the treatment of nodular basal cell carcinoma: results of a randomized controlled trial.
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Fractionated 5-aminolaevulinic acid-photodynamic therapy vs. surgical excision in the treatment of nodular basal cell carcinoma: results of a randomized controlled trial.

机译：分级5-氨基戊酸光动力疗法与手术切除治疗结节性基底细胞癌：一项随机对照试验的结果。

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BACKGROUND: Skin cancer incidence rates have been increasing for decades and this increase is expected to continue. Surgical excision (SE) is the treatment of first choice for nodular basal cell carcinoma (nBCC). Photodynamic therapy (PDT) has proven to be an effective treatment for superficial basal cell carcinoma. Its long-term efficacy in nBCC has not yet been established. OBJECTIVES: Prospectively compare the efficacy of 5-aminolaevulinic acid (ALA)-PDT and SE in terms of failure rates with long-term follow-up. Determinants of failure in the study population, such as the effect of tumour depth, were analysed retrospectively. METHODS: A randomized controlled trial in 173 primary nBCCs in 149 patients. Primary nBCCs were randomly assigned either to PDT (n = 85) or to SE (n = 88). Tumours treated with PDT were illuminated twice on the same day, 4 h after application of ALA cream, 3 weeks after debulking. SE was performed under local anaesthesia with a 3-mm margin, followed by histological examination.An intention-to-treat analysis was performed. RESULTS: In total, 171 primary nBCCs in 149 patients were treated. A 3-year interim analysis revealed that the cumulative incidence of failure was 2.3% for SE and 30.3% for PDT (P < 0.001). Tumour depth and other analysed determinants of failure were not significantly related to treatment failure. CONCLUSIONS: SE proved to be significantly more effective than treatment with fractionated illumination ALA-PDT. Therefore, in the treatment of primary nBCC, SE is preferred over PDT following this treatment regimen.
机译：背景：皮肤癌的发病率已经增加了数十年，并且预计这种增加将持续下去。手术切除（SE）是结节性基底细胞癌（nBCC）的首选治疗方法。光动力疗法（PDT）已被证明是治疗浅表性基底细胞癌的有效方法。在nBCC中的长期疗效尚未确定。目的：就长期随访的失败率而言，前瞻性地比较了5-氨基戊酸（ALA）-PDT和SE的疗效。回顾性分析研究人群失败的决定因素，例如肿瘤深度的影响。方法：随机对照试验在149例患者中进行了173例原发性nBCC。将主要的nBCC随机分配给PDT（n = 85）或SE（n = 88）。在应用ALA乳膏4小时后，在消灭3周后的同一天，两次用PDT治疗的肿瘤被照亮两次。 SE在局麻下进行，边缘为3mm，然后进行组织学检查，并进行意向性治疗分析。结果：总共治疗了149例患者中的171例原发性nBCC。一项为期3年的中期分析显示，SE的失败累积发生率是PDT的累积失败率为30.3％（P <0.001）。肿瘤深度和其他分析失败的决定因素与治疗失败无明显关系。结论：SE被证明比分光ALA-PDT治疗更有效。因此，在原发性nBCC的治疗中，按照该治疗方案，SE优于PDT。

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