MAL-PDT for difficult to treat nonmelanoma skin cancer
William G Stebbins1, C William Hanke
1The Laser and Skin Surgery Center of Indiana, Carmel, Indiana 46032, USA.
Abstract:
With an incidence of over 3.5 million nonmelanoma skin cancers (NMSCs) per year in the United States, there is an increasing need for effective, cost-effective treatments for NMSC. When surgical excision is impractical or not feasible, methyl aminolevulinate photodynamic therapy (MAL-PDT) has demonstrated consistently high long-term cure rates ranging from 70-90%, with superior cosmetic outcomes compared with other treatment modalities. With the exception of invasive squamous cell carcinoma, MAL-PDT has been successful in treating all types of NMSC, especially in patients with multiple comorbidities, field cancerization, and lesions in cosmetically sensitive locations. Herein, a step-by-step description of the procedure for MAL-PDT is provided, followed by a review of outcomes from large clinical trials performed over the past 15 years for each variant of NMSC. After reading this review, clinicians should have a thorough understanding of the benefits and limits of MAL-PDT, and should be able to add this valuable procedure to their armamentarium of therapies for NMSC.
Insights
Methyl aminolevulinate photodynamic therapy (MAL-PDT) offers high cure rates (70-90%) and superior cosmetic outcomes for nonmelanoma skin cancers (NMSCs). This effective treatment is ideal when surgery is not feasible, particularly for multiple or sensitive lesions.
Area of Science:
- Dermatology
- Oncology
- Photomedicine
Background:
- Nonmelanoma skin cancers (NMSCs) affect over 3.5 million individuals annually in the U.S.
- There is a growing demand for cost-effective NMSC treatments beyond surgical excision.
- Methyl aminolevulinate photodynamic therapy (MAL-PDT) presents a viable alternative.
Observation:
- MAL-PDT achieves high long-term cure rates (70-90%) for various NMSCs.
- Cosmetic outcomes with MAL-PDT are superior to other treatment modalities.
- The therapy is effective for patients with multiple comorbidities, field cancerization, and lesions in cosmetically sensitive areas.
Findings:
- MAL-PDT demonstrates efficacy across all NMSC types, excluding invasive squamous cell carcinoma.
- Clinical trials over 15 years confirm the effectiveness and safety of MAL-PDT.
- Procedure details and outcomes for each NMSC variant are reviewed.
Implications:
- MAL-PDT provides clinicians with a valuable therapeutic option for NMSC management.
- The review aims to equip healthcare providers with comprehensive knowledge of MAL-PDT benefits and limitations.
- Enhanced understanding can lead to broader adoption of MAL-PDT for NMSC treatment.
