Comparison of treatment of basal cell carcinoma between surgery and intralesional photodynamic therapy: A cross-sectional study.

BACKGROUND: Surgery is the treatment of choice in basal cell carcinoma (BCC), but new less invasive techniques are in development such as photodynamic therapy. The main problem of this technique is the limited depth penetration of topical photosensitizers. The use of an intralesional photosensitizer plus an irradiation with a 630 nm laser should increase this penetration.

OBJETIVES: To compare the effectiveness in treatment of BCC between surgery and intralesional photodynamic therapy (I-PDT). To identify the clearance rate differences between intralesional or external irradiation in I-PTD group.

METHODS: A retrospective study of 102 patients with different histological types of BCC (mean depth of 2.44 mm) was performed. A total of 51 patients were treated with surgery and 51 with I-PDT, injecting 5-aminolevulinic acid 1% in the tumor and later irradiated with a 630 nm laser (intralesionally or externally: 25 and 26 patients respectively). Histological samples were obtained before and after treatment.

RESULTS: A total of 41/51 Patients in the surgery group vs 42/51 patients in I-PDT group achieved a complete clearance after treatment (p 0.79). There were no differences in success rates between intralesional vs external irradiation in I-PDT group (p 0.46).

LIMITATIONS: Small sample size and retrospective study.

CONCLUSION: I-PDT achieved high clearance rates in the treatment of BCC similar to surgery. There were no differences in success rates between intralesional vs external irradiation in I-PDT group. PDT might be an interesting option of treatment where surgery it is not possible.