Background

Artificial white LED light photodynamic therapy (awl-PDT) is an effective, pain-free treatment for actinic keratosis. The efficacy of awl- PDT in the treatment of superficial basal cell carcinoma (sBCC) has not been assessed.

Methods

Patients with histologically-confirmed sBCC underwent two treatments of awl-PDT one week apart. Lesions were incubated with MAL for 30 minutes and then illuminated using the Maquet Power LED 500 theatre light (405-800nm, 140,000 lux) to deliver an equivalent red light dose of 75 J/cm2 at a rate of 55 mW/cm2. Pain was measured using a visual analogue scale during treatment. Clinical response was assessed at day 28. Follow-up continued 3-monthly for 1 year. Cosmetic outcome was assessed at three months and one year.

Results

Twenty-eight patients with 36 lesions and a mean age of 63.64 (SD 2.62) were recruited. The median lesion size was 15mm (IQR 8.75). The response rate at day 28 was 100%. Recurrence rates were 3/36 (8.3%) at three months, 6/36 (16.7%) at six months, 10/36 (27.8%) at nine months, and 11/36 (30.6%) at one year. Median pain scores were 0/100 (IQR 0) and 0/100 (IQR 5) during treatments one and two, respectively. Cosmetic outcome was excellent or good in the majority of cases.

Conclusion

Although initially effective for sBCC at 28 days, 30.6% of lesions recurred one year after awl-PDT. Pain scores were negligible and the cosmetic outcome was favourable. Further head-to-head studies with optimised protocols are required to determine if awl-PDT has a role in the treatment of sBCC.