Fractionated Illumination Significantly Improves the Response of Superficial Basal Cell Carcinoma to Aminolevulinic Acid Photodynamic Therapy

de Haas, Ellen R.M.; Kruijt, Bastiaan; Sterenborg, Henricus J.C.M.; Martino Neumann, H.A.; Robinson, Dominic J.

doi:10.1038/sj.jid.5700460

Cited by 118Nonmelanoma Skin Cancer StudiesPhotodynamic Therapy Research StudiesHead and Neck Cancer Studies

Fractionated Illumination Significantly Improves the Response of Superficial Basal Cell Carcinoma to Aminolevulinic Acid Photodynamic Therapy

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de Haas, Ellen R.M., Kruijt, Bastiaan, Sterenborg, Henricus J.C.M., Martino Neumann, H.A., Robinson, Dominic J.·2006·Journal of Investigative Dermatology

DOI 10.1038/sj.jid.5700460

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Abstract

Photodynamic therapy (PDT) of superficial basal cell carcinoma (sBCC) using topical 5-aminolevulinic acid (ALA) and a light fluence of 75-100 J cm(-2) yields unsatisfactory long-term results. In several animal models, illumination with two light fractions 2 hours apart was considerably more effective than single illumination. Response is further enhanced if the fluence of the first light fraction is reduced, although the cumulative fluence is maintained. We compared the response of sBCC to a single illumination and 2-fold illumination scheme in which two light fractions of 20 and 80 J cm(-2) are performed 4 and 6 hours after the application of a single dose of 20% ALA. We randomly assigned 154 patients with a total of 505 primary sBCC into two treatment groups. Two hundred and forty-three lesions were treated using a single illumination of 75 J cm(-2) at a fluence rate of 50 mW cm(-2). Fractionated PDT, at the same fluence rate, was performed on 262 lesions. The complete response (CR) following a 2-fold illumination scheme is significantly greater than that following a single light fraction (P=0.002, log-rank test). Twelve months after therapy, CR rate to a 2-fold illumination is 97%, whereas the CR to a single illumination is 89%.

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Compared with single-illumination PDT, double-illumination PDT resulted in a significantly higher complete response rate at one year after treatment in patients with AK or superficial BCC lesions.
“Compared with single-illumination PDT, double-illumination PDT resulted in a significantly higher complete response rate at one year after treatment in patients with AK [66] or superficial BCC [65] lesions.”
From 5-Aminolevulinic Acid as a Theranostic Agent for Tumor Fluorescence Imaging and Photodynamic Therapy (2023) · cites this paper as [65]
PDT protocols with fractionated light illumination enhance PDT outcomes.
“PDT protocols with fractionated light illumination have been shown to enhance PDT outcomes [65].”
From 5-Aminolevulinic Acid as a Theranostic Agent for Tumor Fluorescence Imaging and Photodynamic Therapy (2023) · cites this paper as [65]
A double-illumination PDT scheme with 20 and 80 J/cm2 at 4 and 6 h after topical ALA application yields a much better clinical response than conventional single 75 J/cm2 illumination at 4 h after ALA.
“Particularly, a double-illumination PDT scheme with 20 and 80 J/cm2 at 4 and 6 h after topical ALA application yields a much better clinical response than conventional single 75 J/cm2 illumination at 4 h after ALA.”
From 5-Aminolevulinic Acid as a Theranostic Agent for Tumor Fluorescence Imaging and Photodynamic Therapy (2023) · cites this paper as [65]

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Treatment of superficial basal cell carcinoma by topical photodynamic therapy with fractionated 5-aminolaevulinic acid 20% vs. two-stage topical methyl aminolaevulinate: results of a randomized controlled trial
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Authors: de Haas, E. R. M., Kruijt, B., Sterenborg, H. J. C. M., Martino Neumann, H. A., & Robinson, D. J.
Affiliations: Erasmus MC (NL)
ORCID: Sterenborg, Henricus J.C.M.
Robinson, Dominic J.
Venue: Journal of Investigative Dermatology
Publisher: Elsevier BV
Published: 2006-12
Volume: 126
Issue: 12
Pages: 2679-2686
ISSN: 0022-202X (ISSN-L)
DOI: 10.1038/sj.jid.5700460
OpenAlex: W2030663435
Cited by: 118
References: 42
Citations by year: 2026: 1 · 2025: 6 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 5 · 2020: 5 · 2019: 3 · 2018: 6 · 2017: 2 · 2016: 7 · 2015: 4 · 2014: 4 · 2013: 13 · 2012: 7
FWCI: 6.86
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 3288 d)
Locations: Journal of Investigative Dermatology (publishedVersion, cc-by)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Nonmelanoma Skin Cancer Studies
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Photodynamic Therapy Research Studies
Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
Keywords: superficial basal cell carcinoma, photodynamic therapy, 5-aminolevulinic acid, light fluence, complete response, topical photosensitizer, skin cancer treatment
MeSH terms: Adult, Aged, Aged, 80 and over, Aminolevulinic Acid, Basal Cell Carcinoma, Carcinoma, Basal Cell, Darkness, Humans, Light, Middle Aged, Photochemotherapy, Skin Neoplasms, Time Factors, Treatment Outcome, Photosensitizing Agents

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Fractionated Illumination Significantly Improves the Response of Superficial Basal Cell Carcinoma to Aminolevulinic Acid Photodynamic Therapy

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