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Review
. 2015 Oct 28;16(10):25912-33.
doi: 10.3390/ijms161025912.

Combined Treatments with Photodynamic Therapy for Non-Melanoma Skin Cancer

Silvia Rocío Lucena  1 , Nerea Salazar  2 , Tamara Gracia-Cazaña  3   4 , Alicia Zamarrón  5 , Salvador González  6   7 , Ángeles Juarranz  8 , Yolanda Gilaberte  9   10
Affiliations
Review

Combined Treatments with Photodynamic Therapy for Non-Melanoma Skin Cancer

Silvia Rocío Lucena et al. Int J Mol Sci. .

Abstract

Non-melanoma skin cancer (NMSC) is the most common form of cancer in the Caucasian population. Among NMSC types, basal cell carcinoma (BCC) has the highest incidence and squamous cell carcinoma (SCC) is less common although it can metastasize, accounting for the majority of NMSC-related deaths. Treatment options for NMSC include both surgical and non-surgical modalities. Even though surgical approaches are most commonly used to treat these lesions, Photodynamic Therapy (PDT) has the advantage of being a non-invasive option, and capable of field treatment, providing optimum cosmetic outcomes. Numerous clinical research studies have shown the efficacy of PDT for treating pre-malignant and malignant NMSC. However, resistant or recurrent tumors appear and sometimes become more aggressive. In this sense, the enhancement of PDT effectiveness by combining it with other therapeutic modalities has become an interesting field in NMSC research. Depending on the characteristics and the type of tumor, PDT can be applied in combination with immunomodulatory (Imiquimod) and chemotherapeutic (5-fluorouracil, methotrexate, diclofenac, or ingenol mebutate) agents, inhibitors of some molecules implicated in the carcinogenic process (COX2 or MAPK), surgical techniques, or even radiotherapy. These new strategies open the way to a wider improvement of the prevention and eradication of skin cancer.

Keywords: Bowen disease; actinic keratosis; aminolevulinic acid; basal cell carcinoma; methyl-aminolevulinic acid; photodynamic therapy; squamous cell carcinoma; tumor resistance.

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Figures

Figure 1
Figure 1
Formation process, clinical and histological appearance of basal cell carcinoma and squamous cell carcinoma.
Figure 2
Figure 2
Treatments and procedures that have been combined with photodynamic therapy to treat non-melanoma skin cancer.
Figure 3
Figure 3
(a) Patient with recurrent Bowen disease after surgery and a cycle of methyl-aminolevulinate photodynamic therapy (MAL-PDT) (two sessions one week apart using 37 J·cm−2 Aktilite® (Galderma SA, París, France); (b) Tumor persists one month after a second cycle of MAL-PDT and before treatment with topical imiquimod, five days per week during six weeks. (c) No recurrence after nine months of follow-up.
See this image and copyright information in PMC

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