Table 10.
Photodynamic therapy regimens
| Study and No of SCCs | Photosensitiser or occlusion time | Light source, irradiance,dose | Treatment regimen | Prognostic features* |
|---|---|---|---|---|
| Baptista 2006 (n=4) | Topical 20% ALA, 4-6 h | 630 nm for 1000 s at 100 mW/cm2; total dose 100 J/cm2 | Up to 5 treatments | No data |
| Calzavara-Pinton 1995 (n=18) | Topical 20% ALA, 6-8 h | 630 nm for 10-15 min until slight pain or burning stopped at 100mW/cm2; total dose 60-80 J/cm2 | Every other day until area eroded without clinically evident tumour, or stopped when no further improvement after 2 further treatments | Diameter: superficial SCCs median 18 mm (range 12-45); nodular median 15 mm (range 5-25) |
| Calzavara-Pinton 2008 (n=71) | Topical 160 mg/g MAL, 3 h | 635±18 nm at 37 J/cm2 at irradiance of 86 mW/cm2 | 2 treatments, 7 days apart | Mean diameter 20 mm (range 15-30); depth: Clark levels II (56%), III/IV (44%) |
| Fink-Puchs 1998 (n=35) | Topical 20% ALA oil in water, 4 h | Either unfiltered full spectrum visible light or filtered light of >515 nm or >570 nm or >610 nm, for 5-30 min; median total light dose 61 J/cm2 | 1 treatment | Diameter 1.6-6 cm; depth confined to papillary dermis |
| Fritsch 1998 (n=36) | Topical 20% ALA, 4-6 h | Incoherent light source 570-750 nm for 20 min; 80mW/cm2 for superficial SCCs up to 150 mW/cm2 for nodular and exulcerated SCCs; total dose 96-180 J/cm2 | Maximum 3 treatments (1 month apart) | Diameter 0.5-3.1 cm; 28 SCCs described as “superficial”† |
| Haddad 2004 (n=43) | Topical 20% ALA, 16 h | Non-laser light at 580-720 nm and 1250-1600 nm for 10 min at 100 J/cm2 | 1-3 treatments | Mean diameter 1.4±0.8 cm (range 1-3) |
| Harth 1998 (n=5) | Modified topical 20% ALA plus 2% EDTA and 2% DMSO, 12 h | Red light (585-720 nm) at 150 mW/cm2 and near infrared (1.25-1.6 mm) at 50 mW/cm2 for 10-15 min | 1-3 treatments | “Superficial” |
| Kennedy 1990 (n=8) | Topical 20% ALA, 3-6 h | Filtered light >600 nm at 150-300 mW/cm2 for 3.5-30 min; total dose 15-150 mW/cm2 | Treatment repeated weekly for 2 elevated SCCs | 6 early invasive SCCs; 2 elevated SCCs |
| Lui 1995 (n=2) | Topical 20% ALA, 3 h | Red light at 19-44 mW/cm2; total dose 100 J/cm2 | 1 treatment | Diameter >5 mm |
| Wolf 1993 (n=6) | Topical 20% ALA oil in water, 4-8 h | Unfiltered light at 100 mW/cm2 for 15 min or red light at 100 mW/cm2 for 30 min; total dose 90 J/cm2 | No of treatments not specified | Diameter 1-6 cm; depth: all early invasive |
| Ziokolwski 2004 (n=23) | Group 1: topical 20% ALA plus 5% DMSO and 5% EDTA, 4 h occlusion; group 2: topical 20% ALA plus 5% DMSO, 5% EDTA, and glycolic acid, 4 h occlusion | 650 nm ±30 nm light at 100 mW/cm2; total dose 85-87.6 J/cm2 | Up to 3 sessions of treatment | Group 1 diameter 2-7 mm, group 2 diameter 2-9 mm |
| Feyh 1990 (n=5) | Systemic haematoporphyrin derivative 2 h before photodynamic therapy; dose not specified | 630nm laser light at 100 mw/cm2; dose 100 J/cm2 | — | All tumour stage T1 |
| Kubler 1999 (n=9) | mTHPC at 0.15mg/kg, intravenous, 96 h before photodynamic therapy | 652 nm red light at 100 mW/cm2; total dose 20 J/cm2 | — | No data |
| Pennington 1988 (n=32) | Systemic haematoporphyrin derivative as 5 mg/kg intravenous bolus, 3 days before photodynamic therapy | 630 nm coherent light at 30 J/cm2 | — | Estimated maximal thickness <1 cm |
ALA=aminolevulinic acid; MAL=methylaminolevulinate; EDTA=ethylenediaminetetraacetic acid; DMSO=dimethyl sulfoxide; mTHPC=meta-tetrahydroxyphenylchlorin.
*Percentages indicate proportion of SCCs in study.
†”Superficial” not defined.