Terapia fotodinâmica com metil aminolevulinato no tratamento de 84 pacientes com carcinoma basocelular

• Autor(a) principal: Taborda, Valéria Brega Alvares
• Data de Publicação: 2014
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da USC
• Texto Completo: http://tede2.usc.br:8080/jspui/handle/tede/242
• topic: CARCINOMA BASOCELULAR; TERAPIA FOTODINÂMICA; FOTOQUIMIOTERAPIA; BASAL CELL CARCINOMA; PHOTODYNAMIC THERAPY; PHOTOCHEMOTHERAPY; CIENCIAS DA SAUDE::ODONTOLOGIA

Introduction: Topical photodynamic therapy (PDT) using methyl 5-aminolevulinate (MAL), also known as MAL-PDT, is currently the only licensed form of PDT for the treatment of basal cell carcinoma (BCC). Long-term follow-up studies are also now available, indicating that MAL-PDT has recurrence rates equivalent to other standard therapies in superficial BCC, such as surgery, cryosurgery and electrosurgery. Studies suggested otherwise lower sustained efficacy than surgery and Mohs micrographic surgery in nodular BCC. Objective: To evaluate the clinical and cronological results of topical photodynamic therapy in the treatment of BCC patients. Methodology: This work was a prospective and observational study conducted on 84 Brazilian patients with 112 skin lesions clinical and histopathologically diagnosed as either superficial BCC or thin nodular BCC who thereafter undergone PDT treatments between 2007 and 2013. There was a 1 to 5 years follow-up period. Results: The 84 patients (47 females and 37 males) with ages ranging from 31 to 87 years (mean age of 62.7) 63 had BCC single-lesions (63/84; 75%) and 21 had CBC multiple-lesions (21/84; 25%). To this treatment 11 patients (11/84: 13.09%) had relapsed, representing 9.82% (11/112) of the total BCC lesions. Discussion: The clearance rate was 90,18% (101/112 lesions) after 2 sessions (57/84; 67,86%) or 3 sessions (27/84; 32,14%) of MAL-PDT, similarly to the literature results (86-93%). Among the 11 patients with recurrence there was 9,52% (6/63) single-lesion patients and 23,8% (5/21) multiple-lesion patients, suggesting the patients with multiple lesions may be more likely to relapse after MAL-PDT. Pain was the most common adverse effect being claimed by all patients and there was no significant difference found in the literature. Conclusion: Despite its challenging treatment-related pain discomfort, MAL-PDT remains as a well tolerated treatment modality for BCC, with good aesthetic results and high clearance rates