Ocular preservation through limited tumor excision combined with ALA-PDT in patients with periocular basal cell carcinoma.

Abstract

BACKGROUND\nIn recent years, photodynamic therapy (PDT) is a kind of technique for treating non-melanoma skin cancers in clinical practice compared with traditional methods such as surgical operation, chemotherapy, radiotherapy, and the immunity treatment, etc. PDT offer comprehensive alternatives to previous tumor treatment regimens due to its excellent aesthetic results and skin function preservation effects, especially so for tumor in difficult-to-treat areas. Our purpose of this article was to study the anti-tumor effect of ALA-PDT combined with limited excision in periocular basal cell carcinoma (BCC) and its role in improving the effect of the operation.\n\n\nMETHODS\nIn our study, 8 patients with periocular basal cell carcinoma were treated with topical aminolevulinic acid photodynamic therapy (ALA-PDT) combined with surgery. After removal of tumor mainly with normal tissue saved, each tumor region was irradiated with 177\u2009J/cm2 using a 635-nm laser for 15\u2009min. A total of 3 times of assisted ALA-PDT was applied during and after operation. BCC was confirmed by pathological examination and the structure of tumor tissues was observed by transmission electron microscopy.\n\n\nRESULTS\nTransmission electron microscopy showed that PDT had inhibitory effects on the growth of BCC by causing necrosis of tumor cells. There was no recurrence in the follow-up of 2.8 years (range, 0.6-5 years). The patients with infiltrative orbital BCC were able to complete the treatment protocolwith well cosmetic results and no significant side effects.\n\n\nCONCLUSIONS\nPDT is a safe, effective and non-invasive approach for treating orbital BCC. Topical PDT during and after operation can reduce the excision range of the tumor lesions. Therefore, PDT plays a positive role in the treatment of periocular basal cell carcinoma.