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Effectiveness of photodynamic therapy in Bowen's disease: a retrospective observational study in 423 lesions

Journal article
Authors Oscar Zaar
J. Fougleberg
A. Hermansson
Martin Gillstedt
Ann-Marie Wennberg Larkö
John Paoli
Published in Journal of the European Academy of Dermatology and Venereology
Volume 31
Issue 8
Pages 1289-1294
ISSN 0926-9959
Publication year 2017
Published at Institute of Clinical Sciences, Section for Oncology, Radiation Physics, Radiology and Urology, Department of Dermatology and Venereology
Pages 1289-1294
Language English
Links doi.org/10.1111/jdv.14164
Keywords squamous-cell carcinoma, in-situ, cryotherapy, Dermatology
Subject categories Dermatology and Venereal Diseases

Abstract

BackgroundPhotodynamic therapy (PDT) is a well-known technique that is often used for treating superficial precancerous and cancerous skin lesions. However, only a handful of studies, with a relatively small number of treated lesions, have been carried out on the effectiveness of PDT for Bowen's disease (BD). ObjectivesThis study aimed to assess the effectiveness and recurrence risk of PDT in the treatment of BD. The secondary objectives were to determine what factors affected the response rates and the cosmetic result of the treatment. MethodIn this retrospective observational study, the electronic patient charts at Sahlgrenska University Hospital (SUH) in Gothenburg, Sweden, were searched to find all patients diagnosed with BD who were treated with PDT between 1 January 2002 and 31 December 2014. Data were collected regarding clinical response at the first follow-up visit, recurrences during later follow-up visits and other relevant patient and tumour characteristics. ResultsIn total, 423 BD lesions in 335 patients were included in the study. The mean FU duration was 11.2 months (range 0.2-151 months). The complete response rate at the first FU visit was 77.5% for all BD lesions. During later FU visits, another 60 recurrences were observed, which resulted in a recurrence rate of 18.3%. Thus, the overall clearance rate after FU was 63.4% for all BD lesions. Significant risk factors for unsuccessful treatment in this study were large lesion size (>2 cm) and a single PDT session. ConclusionThis study shows that PDT is a relatively effective treatment modality for BD.

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