Special ArticleGuidelines on the use of photodynamic therapy for nonmelanoma skin cancer: An international consensus
Section snippets
Method
These recommendations were developed during a meeting of the International Society for Photodynamic Therapy in Dermatology in January 2005. A systematic literature review was conducted (using MEDLINE), and recommendations were made based on the quality of evidence for efficacy, safety/tolerability, cosmetic outcome, and patient satisfaction/preference. Cosmetic outcome and patient preference are important considerations when treating superficial NMSCs, which generally respond well to treatment
Epidemiology of NMSCs
NMSCs are the most common malignancies in the Caucasian population, accounting for more than one third of all adult cancers in the United States, with approximately 900,000 to 1,200,000 new cases per year,3 up to 18- to 20-fold more than malignant melanoma.4 The incidence of NMSC has been steadily increasing worldwide at a rate of 3% to 8% per year since 1964,5 with greater increases nearer the equator.6 In Australia, the incidences of squamous cell carcinoma (SCC) and basal cell carcinoma
Actinic keratosis
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PDT is a highly effective treatment for AK, offering the advantage of excellent cosmetic outcome, and should therefore be considered as a first-line therapy. AI
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MAL-PDT has a superior cosmetic outcome compared with cryotherapy. AI
Bowen's disease
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Topical PDT is effective in BD, achieving good cosmesis, and is at least as effective as cryotherapy or 5-FU, but with fewer adverse events. Topical PDT should be considered as a first-line therapy for BD. AI
Squamous cell carcinoma
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There is insufficient evidence to support the routine use of
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Cited by (0)
The recommendations set forth in this article have been prepared for dermatologists on behalf of the International Society for Photodynamic Therapy in Dermatology and reflect the best data available at the time this report was prepared. Caution should be exercised in interpreting the data; the results of future studies may require alteration of the conclusions or recommendations of this report. It may be necessary or even desirable to depart from the recommendations in the interests of specific patients or special circumstances. Just as adherence to these recommendations may not constitute a defense against a claim of negligence, so deviation from them should not necessarily be deemed negligent.
Funding sources: The work of the IPDT was supported by an educational grant from Galderma International, Paris, France.
Disclosure: Dr Braathen has received speakers' honoraria from Galderma International. He is currently a consultant for PhotoCure. The department of Dermatology, chaired by Dr Braathen, has received financial support from Galderma International and PhotoCure for performing clinical trials. Dr Szeimies received financial support for performing clinical trials, has served as a consultant for, and has received speakers' honoraria from Galderma International. He has received financial support from Biocam GmbH, Energist, Medac, 3M, PhotoCure, Waldmann Medizintechnik, and Wavelight AG for performing clinical trials. Dr Basset-Seguin does consultant work for Galderma and has a consultancy agreement with 3M. Dr Bissonnette has served as a consultant and received research grants to conduct clinical trials from PhotoCure. He has received research grants to conduct basic and clinical trials from DUSA Pharmaceuticals, QLT Inc, and Quest Pharmatech. Dr Foley has been paid for PDT trials sponsored by PhotoCure ASA, Galderma, and QLT; and non-NMSC trials by Peplin and 3M. He has received honoraria and travel bureaux from PhotoCure and Galderma for presentations at national and international congresses and symposia and has received honoraria for attending meetings as a member of Galderma Australia's Medical Advisory Board. He has acted as a consultant to Galderma Australia, 3M Australia, and Peplin. Dr Pariser has served as an investigator and consultant with Galderma International and an investigator with PhotoCure and DUSA Pharmaceuticals. Dr Wennberg has taken part in clinical trials with Galderma International, Photocure, 3M, and Fujisawa. She has received fees for giving lectures from Galderma International, PhotoCure, 3M, Fujisawa, and Schering Plough. Dr Morton has received financial support for performing clinical trials and speakers' honoraria from Galderma. He has received travel scholarships from 3M, PhotoCure, and Phototherapeutics Ltd and has received support for performing clinical trials from PhotoCure and Schering AG.