氨基酮戊酸-光动力疗法治疗皮肤肿瘤的临床分析

The efficacy of aminolevulinic acid photodynamic therapy in the treatment of skin cancers

目的：探讨5‐氨基酮戊酸光动力治疗皮肤癌及癌前病变的疗效。方法对2010—2015年本院皮肤科门诊53例皮肤恶性肿瘤患者，均为临床和组织病理确诊患者，进行ALA‐PDT 治疗，20％ ALA霜剂涂于皮损，4 h后激光照射，能量为100～120 J／cm2时间约为40 min。结果所有病例经过8～15个月随访（平均10个月）的随访，18例浅表型基底细胞癌，治疗有效率88．8％，平均治疗次数4．14次；15例浅表型鳞状细胞癌，治疗有效率66．67％，平均治疗次数4．75次；12例鲍温病，治疗有效率41．6％，平均治疗次数5．20次；8例Paget病，治疗有效率37．5％，平均治疗次数5．10次。病变处皮肤愈合后见轻微色素沉着，未见瘢痕形成。结论 ALA‐PDT 对及癌前病变及皮肤癌具有疗效好、无痛苦、无创伤、无疤痕形成、复发率低的特点，尤其适用于年迈体弱及特殊部位的皮肤肿瘤患者。

Objective To study the efficacy of aminolevulinic acid photodynamic therapy （ALA‐PDT） in the treatment of skin cancers and precancerous lesions .Methods A total of 53 confirmed cases of malignant skin canc‐er during 2010-2015 received ALA‐PDT .Four hours after 20% ALA cream was applied onto the skin ,patients un‐derwent laser irradiation with energy of 100‐120 J/cm2 for 40 minutes .Results All patients were followed up for 8‐15 months （mean 10 months） .The effective rate of 18 cases of superficial basal cell carcinoma was 88 .8% ,and pa‐tients received 4 .14 times of treatment .The effective rate of 15 cases of superficial squamous cell carcinoma was 66.67% ,and patients received 4 .75 times of treatment .The effective rate of 12 cases of Bowen disease was 41 .6% , and patients received 5 .20 times of treatment .The effective rate of 8 cases of Paget＇s disease was 37 .5% ,and pa‐tients received 5 .10 times of treatment .After skin healing slight pigmentation could be observed ,but no scars were found .Conclusions ALA‐PDT is effective and minimal invasive in the treatment of skin cancers and precancerous lesions .It has advantages of few scar formation and low recurrence rate .It is especially suitable for elderly patients and skin cancer on special sites .