Cited by 285Nonmelanoma Skin Cancer StudiesPhotodynamic Therapy Research StudiesSkin Protection and Aging

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A comparison of photodynamic therapy using topical methyl aminolevulinate (Metvix®) with single cycle cryotherapy in patients with actinic keratosis: a prospective, randomized study

Freeman, M, Vinciullo, C, Francis, D, Spelman, L, Nguyen, R, Fergin, P, Thai, K‐E, Murrell, D, Weightman, W, Anderson, C, Reid, C, Watson, A, Foley, P·2003·Journal of Dermatological Treatment

DOI 10.1080/09546630310012118

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Abstract

BACKGROUND: Actinic keratosis (AK) is a very common condition, which has the potential of progressing to squamous cell carcinoma. The present study is a prospective, randomized study comparing the lesion response, cosmetic outcome, patient satisfaction and tolerability of a new treatment modality, photodynamic therapy (PDT), using topical methyl aminolevulinate (Metvix), with the most commonly used standard therapy for AK, cryotherapy. METHODS: A total of 204 patients with clinically diagnosed AK were randomized to either cryotherapy or PDT. The PDT patients were further assigned to an active or placebo group in a random, double-blind manner. Cryotherapy was performed using liquid nitrogen spray in a single freeze-thaw cycle. PDT was performed using 160 mg/g methyl aminolevulinate cream or placebo, a 3-hour application time, red light (570-670 nm) and a total light dose of 75 J/cm(2). PDT was repeated after 7 days. Two sessions of PDT were undertaken, as a previous study had shown a single session had similar efficacy to cryotherapy. Lesion response was assessed clinically after 3 months (complete response or non-complete response). RESULTS: The lesion response rate was 91% in the methyl aminolevulinate PDT group, 68% in the cryotherapy group and 30% in the placebo PDT group. Methyl aminolevulinate PDT was statistically significantly better than both cryotherapy and placebo PDT in terms of response rates and cosmetic outcome. Most patients preferred PDT to other treatments. CONCLUSIONS: PDT with methyl aminolevulinate is an excellent treatment option, particularly for patients with widespread damage or AK lesions in cosmetically sensitive areas.

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Authors: Freeman, M., Vinciullo, C., Francis, D., Spelman, L., Nguyen, R., Fergin, P., Thai, K., Murrell, D., Weightman, W., Anderson, C., Reid, C., Watson, A., & Foley, P.
Affiliations: The Skin Centre, Gold Coast, QLD
The Perth Surgicentre, Perth, WA
The Belmont Specialist Clinic, Brisbane, QLD
Skin and Cancer Foundation (AU)
St George Hospital (AU)
Queen Elizabeth Hospital (AU)
Liverpool Hospital (AU)
Royal Adelaide Hospital (AU)
Royal Newcastle Hospital, Newcastle, NSW
St Vincent's Hospital Melbourne (AU)
Corresponding author: Foley, P
ORCID: Vinciullo, C
Spelman, L
Murrell, D
Foley, P
Venue: Journal of Dermatological Treatment
Publisher: Informa UK Limited
Published: 2003-01-01
Volume: 14
Issue: 2
Pages: 99-106
ISSN: 0954-6634 (ISSN-L)
1471-1753
DOI: 10.1080/09546630310012118
OpenAlex: W2007413267
Cited by: 285
References: 21
Citations by year: 2026: 5 · 2025: 6 · 2024: 3 · 2023: 8 · 2022: 7 · 2021: 5 · 2020: 5 · 2019: 6 · 2018: 10 · 2017: 9 · 2016: 16 · 2015: 10 · 2014: 19 · 2013: 5 · 2012: 15
FWCI: 13.63
Type: journal article
Language: en
Open access: closed
Locations: Journal of Dermatological Treatment (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Dermatology › Nonmelanoma Skin Cancer Studies
Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Photodynamic Therapy Research Studies
Health Sciences › Medicine › Dermatology › Skin Protection and Aging
Keywords: actinic keratosis, photodynamic therapy, methyl aminolevulinate, cryotherapy, liquid nitrogen spray, cosmetic outcome, patient satisfaction, treatment tolerability, squamous cell carcinoma prevention
MeSH terms: Administration, Cutaneous, Adult, Aged, Aged, 80 and over, Aminolevulinic Acid, Cryosurgery, Double-Blind Method, Female, Humans, Keratosis, Male, Middle Aged, Photochemotherapy, Prospective Studies, Severity of Illness Index, Victoria, Treatment Outcome, Photosensitizing Agents

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A comparison of photodynamic therapy using topical methyl aminolevulinate (Metvix®) with single cycle cryotherapy in patients with actinic keratosis: a prospective, randomized study

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