Basset-Seguin et al

Title: MAL-PDT vs. cryotherapy in primary sBCC: results of 48-month follow-up.

Author: Basset-Seguin N, Ibbotson S, Emtestam L, Tarstedt M, Morton C, Maroti M, et al.

Journal Reference: J Eur Acad Dermatol Venereol 2005; 19 (Suppl 2):237. 

Objective: to compare the efficacy of photodynamic therapy using topical methyl aminolevulinate (MAL; Metvix®) with standard cryotherapy in the treatment of superficial basal cell carcinoma. 

Design: this phase III trial was a prospective, randomised, comparative, multicentre European study. The patients were adults, males and females, with histologically confirmed superficial basal cell carcinoma that was considered suitable for treatment with cryotherapy. One hundred and eighteen patients were randomised to receive either cryotherapy (n=58) or photodynamic treatment (n=60). All lesions were prepared by curettage to facilitate methyl aminolevulinate (160 mg/g) penetration. Two treatment sessions were given one week apart. Lesions only partly responding at three-month evaluation received two additional treatment sessions, one week apart.
Patients in the cryotherapy group received a double timed freeze-thaw cycle with liquid nitrogen spray. Treatment was repeated at three-month evaluation for lesions that had not completely responded.
Results from follow-up at 48 months of lesions in complete response at 3 months are reported.

Key Results:

  • At three-month follow-up, lesion complete response rate was 97% for photodynamic therapy compared with 95% in the cryotherapy group.
  • The lesion recurrence rate at 48 months after last treatment was 22% for photodynamic therapy and 19% for cryotherapy.
  • At 48-month follow-up, investigators considered cosmetic outcome as good or excellent in 88% of patients with photodynamic therapy and 62% with cryotherapy.

Conclusion: over 48 months of study, photodynamic therapy and cryotherapy give very similar results in the treatment of superficial basal cell carcinoma. However, photodynamic therapy with methyl aminolevulinate cream (MAL; Metvix®) is superior in terms of cosmetic outcome, which may increase patient satisfaction with this treatment modality.