SUPERFICIAL PHOTODYNAMIC THERAPY WITH TOPICAL 5-AMINOLEVULINIC ACID FOR SUPERFICIAL PRIMARY AND SECONDARY SKIN-CANCER

Between January 1991 and December 1992 a phase I trial of superficial photodynamic therapy (PDT) using topical application of 5-aminolaevuli nic acid (ALA) was undertaken to treat Bowen's disease, superficial ba sal cell carcinomas (BCCs) and metastatic skin secondaries from breast (adenocarcinoma) or pinna (squamous cell carcinoma). Promising result s were obtained with 36 areas of Bowen's disease, with a complete resp onse rate of 89% at a median follow-up of 18 months. The treatment of BCCs was less successful, with 50% complete responses in 16 lesions at a median follow-up of 17 months. Metastatic nodules responded poorly. The treatment was well tolerated and discomfort during light irradiat ion could be reduced by prior application of 'Emla' cream. Lesions wep t for 1-2 weeks following treatment and healed over a period of approx imately 2 months. For large areas of Bowen's disease, particularly in anatomically difficult areas and in elderly patients, PDT using ALA ma y constitute a single simple alternative outpatient treatment to exist ing therapies. Further work is required to improve the results with BC Cs.