氨基酮戊酸光动力疗法治疗基底细胞癌

Treatment of Basal Cell Carcinoma with 5-Aminolevulinic Acid Photodynamic Therapy

目的观察氨基酮戊酸-光动力疗法(5-aminolevulinic acid photodynamic therapy,5-ALA-PDT)治疗基底细胞癌的疗效。方法基底细胞癌患者42例,局部采用5-ALA-PDT治疗。20%ALA霜剂涂于患者皮损和周围正常皮肤0.5～1.0 cm处,厚度约1 mm,持续湿敷,外加塑料薄膜封包,4 h后He-Ne激光照射,功率密度100～200 mW/cm2,时间30 min,每次能量密度180～360 J/cm2,两次光动力治疗时间间隔1～2周,共治疗3～6次。结果 42例基底细胞癌中,完全缓解29例,部分缓解8例,总有效率88.1%;39例(92.9%)患者美容效果满意;无一例患者出现严重不良反应。结论局部5-ALA-PDT治疗基底细胞癌安全有效、美容效果好、不良反应少。

Objective To observe the efficacy of topical 5-aminolevulinic acid photodynamic therapy in treating basal cell carcinoma. Methods Totally 42 patients with basal cell carcinoma were given topical 5-aminolevulinic acid photodynamic therapy.A layer of ALA 20% cream,being about 1 mm thick,was applied on the lesion and surrounding areas 0.5-1.0 cm away.The treated area was covered with an occlusive polyethylene dressing for 4 h.Subsequently,the lesions were exposed to He-Ne laser（wavelength： 632.8 nm） for 30 min to deliver a total light dose of 180~360 J/cm2.The treatment was given once every one or two weeks,3 to 6 times in total. Results Of the 42 patients,29 had complete remission,and 8 partial remission,showing a total effective rate of 88.1%.39（92.9%） patients had an excellent or good cosmetic outcome,and no serious adverse reaction occurred in the course of treatment. Conclusions ALA-PDT is safe and effective for patients with basal cell carcinoma,featuring good cosmetic outcome and few adverse reaction.