Efficacy and safety of combination therapy with aminolevulinic acid photodynamic therapy in the treatment of facial basal cell carcinoma in the elderly:a retrospective analysis
Objective To investigate the clinical efficacy and safety of different combination therapies with aminolevulinic acid photodynamic therapy(ALA-PDT)in the treatment of facial basal cell carcinoma in the elderly.Methods A retrospective analysis was conducted on 131 elderly patients with facial basal cell carcinoma who visited Shanghai Skin Disease Hospital from August 2020 to October 2023.According to the depth of the lesions,the patients were divided into 3 groups to receive intensive pretreatment with curettage(41 cases),CO2 laser therapy(35 cases),and narrow-margin excision surgery without sutures(55 cases)respectively,all followed by ALA-PDT.During the follow-up period of 17.7±9.0 months,the efficacy was evaluated and adverse reactions were recorded in each group.Results The total remission rates were 100％,100％,and 96.4％in the curettage+ALA-PDT group,CO2 laser+ALA-PDT group,and narrow-margin excision surgery without sutures+ALA-PDT group,respectively.The patients experienced mild pain and local erythematous swelling during ALA-PDT treatment,which were temporary and fully tolerable,and no wound infections or difficulties in healing were observed.After treatment,scar formation was observed in 3 cases of basal cell carcinoma on the nose and nasolabial folds in the narrow-margin excision surgery without sutures+ALA-PDT group,but the rest of the patients retained a good facial appearance.Conclusions In this preliminary exploration study on PDT for basal cell carcinoma of different depths,ALA-PDT combined with curettage,CO2 laser or narrow-margin excision surgery without sutures all exhibited definite efficacy and minimal damage,providing effective treatment options for facial basal cell carcinoma in the elderly.
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