2025/07/15 by Robert Stephens, Chris Anderson, Rolf B. Saager +2 · 1 voice
Medicine · #Nonmelanoma Skin Cancer Studies #Ocular Oncology and Treatments #Photodynamic Therapy Research Studies
paper · pdf · doi:10.1002/jvc2.70115
openalex publication_date 2025/07/15 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/23
ABSTRACT Background Conventional photodynamic treatment (cPDT) of thin basal cell carcinomas (BCCs) has uncomfortably high rates of incomplete clearance. Incomplete clearance/recurrence rates for superficial BCCs are as high as 40% and even higher for tumours treated on the head and neck. Our experience has been that flushing is more pronounced on the head and neck during cPDT photoactivation. We postulated that haemoglobin, although delivering oxygen, may be acting as a competing chromophore. Objectives To determine whether a 2‐phased photoactivation protocol, in which blood is removed before the second phase intense pulsed light (IPL) activation, improves clearance rates. Methods Retrospective observational study of 206 treatment‐naïve BCCs ≤ 1 mm thickness treated over a 7‐year period with a 2‐phased photoactivation protocol (‘biphasic PDT’). The first phase consists of conventional red‐light activation (20−37 Jcm −2 ). Second phase photoactivation uses IPL (30−45 Jcm −2 ) delivered with sufficient mechanical pressure in the handpiece to blanch the skin. Optical coherence tomography (OCT) has been used to aid in lesion diagnosis, to establish suitability of tumour for treatment and to improve verification of treatment outcomes. Results In the final group of 175 tumours, of which most were located on the head and neck and over 40% were nodular, there were only four incomplete treatments over a 2‐year median follow‐up period (up to 7 years). The few incomplete clearances were easily managed. Conclusions One or two biphasic photodynamic treatments are highly effective (98% clearance) in thin, treatment‐naïve BCCs (≤ 1 mm in thickness) selected on clinical and OCT assessment.