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Selected Publication:
Fink-Puches, R; Hofer, A; Smolle, J; Kerl, H; Wolf, P.
Primary clinical response and long-term follow-up of solar keratoses treated with topically applied 5-aminolevulinic acid and irradiation by different wave bands of light.
J Photochem Photobiol B. 1997; 41(1-2):145-151
Doi: 10.1016/S1011-1344(97)00096-1
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- Leading authors Med Uni Graz
- Fink-Puches Regina
- Wolf Peter
- Co-authors Med Uni Graz
- Hofer Angelika
- Kerl Helmut
- Smolle Josef
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- Abstract:
- Photodynamic therapy with 5-aminolevulinic acid (ALA-PDT) is based on photosensitization by endogenous synthesis of protoporphyrin IX and its transient accumulation especially in malignant epithelially derived tissues. Recent studies have indicated that ALA-PDT is effective for the treatment of solar keratoses (SK), but there has been a lack of long-term clinical follow-up. The goal of the present study was to investigate the immediate and long-term effect of ALA-PDT on SK. Twenty-eight patients with a total of 251 SK were enrolled in the study. Standard treatment involved the topical application of 20% ALA, under occlusive and light-shielding dressing for 4 hours before exposure to UVA and/or different wave bands or wave band combinations of polychromatic visible light (full-spectrum visible light, and/or different wave bands of filtered visible light > 515, > 530, > 570, or > 610 nm) in one or two treatment sessions. The primary complete response rate of SK to ALA-PDT was 64% after one treatment, but 85% when the responses to a second treatment were included. Taken all treatments together, the complete response rate for lesions on face, scalp and neck was 93% for full-spectrum visible light, 96% for the combination of full-spectrum visible light and filtered light, 91% for different wave bands of filtered visible light, and 100% for the combination of long wave UVA and full-spectrum visible light, respectively. The complete response rate for lesions on forearms and hands was 51% for full-spectrum visible light and 33% for the combination of full-spectrum visible light and filtered light. The greater response rate for SK on the face, scalp, and neck was associated with a higher surface fluorescence and immediate response rate after ALA photosensitization at these sites (chi 2; p = 0.0001). However, due to the treatment protocol the mean light dose applied to lesions on the face, scalp and neck (50 J cm-2) was substantially higher than that for lesions on forearms and hands (35 J cm-2). In the long term follow-up of SK on face scalp and neck, the projected disease-free rate at 36 months after therapy was 71% for lesions treated with full-spectrum visible light versus 23% for lesions treated with different wave bands of filtered light (Log rank-Mantel Cox; p = 0.0001). These results indicate that treatment with full-spectrum visible light at higher light doses may be the most effective and promising form of light exposure in ALA-PDT of SK.
- Find related publications in this database (using NLM MeSH Indexing)
- Administration, Topical -
- Aged -
- Aged, 80 and over -
- Aminolevulinic Acid - adverse effects
- Erythema - adverse effects
- Female - adverse effects
- Fluorescence - adverse effects
- Follow-Up Studies - adverse effects
- Humans - adverse effects
- Keratosis - drug therapy
- Light - drug therapy
- Male - drug therapy
- Middle Aged - drug therapy
- Pain - drug therapy
- Photosensitizing Agents - adverse effects
- Sunlight - adverse effects
- Time Factors - adverse effects
- Find related publications in this database (Keywords)
- Photodynamic Therapy
- Aminolevulinic Acid
- Epicutaneous Application
- Primary Response
- Follow-Up