Long-term outcomes following foscan®-PDT of basal cell carcinomas

Background and Objective In a previous publication we showed that mTHPC-PDT (Foscan (R)-PDT) is an effective treatment of basal cell carcinomas (BCCs) in difficult to treat locations and presented optimized treatment parameters to reduce costs and side effects. Now we present long-term results of the same study population. Study Design/Materials and Methods Following PDT of a total of 460 BCCs in 117 subjects, the patients/lesions were followed-up for a mean duration of 42 (range: 272) months. Two patients dropped out of follow-up; 13 patients died of unrelated causes. Recurrences were treated either by repeated PDT or other established methods. Results The sustained clearance rate was 93.7% and the overall treatment success rate was 90.7%. KaplanMeier analysis revealed an estimated recurrence free fraction of patients at 5 years of 95.1%, 92.4%, 85.1%, and 74.0% for the four different photosensitizer dose groups (0.060.15, 0.05, 0.04, and 0.03?mg/kg). High-risk lesions (recurrences, thickness >3?mm) recurred more often than low-risk ones, and recurrences mostly (>50%) occurred during the first year of follow-up. Conclusion Long-term outcomes of high-dose (0.060.15?mg/kg) and reduced-dose (0.05?mg/kg) Foscan (R)-PDT in difficult to treat BCCs compare favorably with other methods, even in high-risk lesions (recurrent and/or thick lesions). A recommended combination of treatment parameters for low-dose therapy seems to be: 0.05?mg/kg Foscan (R), 24?hours druglight interval (DLI), fluence =40?J/cm2. Prospective randomized studies are needed to look into low-dose mTHPC-PDT of BCCs in more detail and to directly compare it with other treatments. Lasers Surg. Med. 44: 533540, 2012. (c) Wiley Periodicals, Inc.