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American Journal of Clinical Dermatology
Published in: American Journal of Clinical Dermatology 4/2001

01-08-2001 | Review Article

Role of Lasers and Photodynamic Therapy in the Treatment of Cutaneous Malignancy

Authors: Dr Sigrid Karrer, Rolf-Markus Szeimies, Ulrich Hohenleutner, Michael Landthaler

Published in: American Journal of Clinical Dermatology | Issue 4/2001

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Abstract

Tumor therapy is not a common indication for the use of lasers, as it is in the treatment of benign vascular skin lesions, since many alternative treatment modalities exist. However, certain patients may benefit from laser therapy of premalignant and malignant skin tumors. Skin tumors can be treated by laser excision, laser coagulation, laser vaporization, or photodynamic therapy (PDT). For these purposes, the carbon dioxide laser, the neodymium:yttrium aluminum garnet laser and the argon laser are particularly suitable. PDT is a therapeutic approach based on the photosensitization of the target tissue by topical or systemic photosensitizers and subsequent irradiation with light from a laser or a lamp inducing cell death via generation of reactive oxygen species.
Laser therapy and PDT have shown good results in the curative treatment of actinic keratoses, superficial basal cell carcinoma, Bowen’s disease and cheilitis actinica. However, they are not recommended for primary malignant melanoma and invasive squamous cell carcinoma. In some patients, lasers and PDT might also be used effectively for the palliative treatment of cutaneous metastases.
In selected patients, lasers and PDT may offer some advantages over routine procedures, e.g. reduction of scarring and better cosmetic results. However, when treating invasive tumors with curative intention, one has to bear in mind the lack of histologic control and the limited depth of tissue penetration of most laser and PDT therapies.
Literature
1.
Landthaler M, Hohenleutner U, editors. Lasertherapie in der Dermatologie. Atlas und Lehrbuch. Berlin, Heidelberg, New York: Springer, 1999
2.
Walker N.P., Matthews J., Newson S.W. Possible hazards from irradiation with the carbon dioxide laser. Lasers Surg Med 1986; 6: 84–86PubMedCrossRef
3.
Landthaler M., Szeimies R.M., Hohenleutner U. Laser therapy of skin tumors. Recent Results Cancer Res 1995; 139: 417–421PubMedCrossRef
4.
Von Tappeiner H., Jodlbauer A. Die sensibilisierende Wirkung fluorescierender Substanzen. Gesammette Untersuchungen über die photodynamische Erscheinung. Leipzig: FCW Vogel, 1907
5.
Auler.H, Banzer G. Untersuchungen über die Rolle der Porphyrine bei geschwulstkranken Menschen und Tieren. Z Krebsforsch 1942; 53: 65–68CrossRef
6.
Szeimies R.M., Sassy T., Landthaler M. Penetration potency of topical applied d-aminolevulinic acid for photodynamic therapy of basal cell carcinoma. Photochem Photobiol 1994; 59: 73–76PubMedCrossRef
7.
Peng Q., Warloe T., Berg K., et al. 5-Aminolevulinic acid-based photodynamic therapy: clinical research and future challenges. Cancer 1997; 79: 2282–2308PubMedCrossRef
8.
Wheeland R.G., Bailin P.L., Ratz J.L., et al. Carbon dioxide laser vaporization and curettage in the treatment of large or multiple superficial basal cell carcinomas. J Dermatol Surg Oncol 1987; 13: 119–125PubMed
9.
Humphrey T.R., Malhotra R., Scharf M.J., et al. Treatment of superficial basal cell carcinoma and squamous cell carcinoma in situ with a high-energy pulsed carbon dioxide laser. Arch Dermatol 1998; 134: 1247–1252CrossRef
10.
Horlock N., Grobbelaar A.O., Gault D.T. Can the carbon dioxide laser completely ablate basal cell carcinomas? A histological study. Br J Plast Surg 2000; 53: 286–293PubMedCrossRef
11.
Landthaler M., Brunner R., Haina D., et al. Der Neodym-YAG-Laser in der Dermatologie. Münch Med Wochenschr 1984; 126: 1108–1102
12.
Kennedy J.C., Pottier R.H. Endogenous protoporphyrin IX, a clinically useful photosensitizer for photodynamic therapy. J Photochem Photobiol B 1992; 14: 275–292PubMedCrossRef
13.
Fink-Puches R., Soyer H.P., Hofer A., et al. Long-term follow-up and histological changes of superficial nonmelanoma skin cancers treated with topical deltaaminolevulinic acid photodynamic therapy. Arch Dermatol 1998; 134: 821–826PubMedCrossRef
14.
Calzavara-Pinton P.G. Repetitive photodynamic therapy with topical deltaaminolevulinic acid as an appropriate approach to the route treatment of superficial non-melanoma skin tumors. J Photochem Photobiol B 1995; 29: 53–57PubMedCrossRef
15.
Svanberg K., Andersson T., Killander D., et al. Photodynamic therapy of non-melanoma malignant tumours of the skin using topical delta-aminolevulinic acid sensitization and laser irradiation. Br J Dermatol 1994; 130: 743–751PubMedCrossRef
16.
Karrer S., Szeimies R.M., Hohenleutner U., et al. Unilateral localized basaliomatosis: treatment with topical photodynamic therapy after application of 5-aminolevulinic acid. Dermatology 1995; 190: 218–222PubMedCrossRef
17.
Meijnders P.J.N., Star W.M., De Bruijn R.S., et al. Clinical results of photodynamic therapy for superficial skin malignancies or actinic keratosis using topical 5-aminolevulinic acid. Las Med Science 1996; 11: 123–131CrossRef
18.
19.
Cox N.H., Eedy D.J., Morton C.A. Guidelines for management of Bowen’s disease. Br J Dermatol 1999; 141: 633–641PubMedCrossRef
20.
Landthaler M., Haina D., Brunner R., et al. Laser therapy of Bowenoid papulosis and Bowen’s disease. J Dermatol Surg Oncol 1986; 12: 1253–1257PubMed
21.
Brunner R., Landthaler M., Haina D., et al. Treatment of benign semimalignant, and malignant skin tumors with the Nd-YAG-laser. Lasers Surg Med 1985; 5: 105–110PubMedCrossRef
22.
Boynton K.K., Bjorkman D.J. Argon laser therapy for perianal Bowen’s disease: a case report. Lasers Surg Med 1991; 17: 385–387CrossRef
23.
Cairnduff F., Stringer M.R., Hudson E.J., et al. Superficial photodynamic therapy with topical 5-aminolevulinic acid for superficial primary and secondary skin cancer. Br J Cancer 1994; 69: 605–608PubMedCrossRef
24.
Stables G.I., Stringer M.R., Robinson D.J., et al. The treatment of Bowen’s disease by topical aminolaevulinic acid photodynamic therapy. Br J Dermatol 1998; 139: 74
25.
Morton C.A., Whitehurst C., Moseley H., et al. Comparison of photodynamic therapy with cryotherapy in the treatment of Bowen’s disease. Br J Dermatol 1996; 135: 766–771PubMedCrossRef
26.
Fritsch C., Lang K., Neuse W., et al. Photodynamic diagnosis and therapy in dermatology. Skin Pharmacol Appl Skin Physiol 1998; 11: 358–373PubMedCrossRef
27.
28.
Jiang S.B., Levine V.J., Nehal K.S., et al. Er: YAG laser for the treatment of actinic keratoses. Dermatol Surg 2000; 26: 437–440PubMedCrossRef
29.
Fulton J.E., Rahimi A.D., Helton P., et al. Disappointing results following resurfacing of facial skin with CO2 lasers for prophylaxis of keratoses and cancers. Dermatol Surg 1999; 25: 729–732PubMedCrossRef
30.
Szeimies R.M., Karrer S., Sauerwald A., et al. Photodynamic therapy with topical application of 5-aminolevulinic acid in the treatment of actinic keratoses: an initial clinical study. Dermatology 1996; 192: 246–251PubMedCrossRef
31.
Jeffes E.W., McCullough J.L., Weinstein G.D., et al. Photodynamic therapy of actinic keratosis with topical 5-aminolevulinic acid: a pilot dose-ranging study. Arch Dermatol 1997; 133: 727–732PubMedCrossRef
32.
Dougherty T.J., Gomer C.J., Henderson B.W., et al. Photodynamic Therapy. J Natl Cancer Inst 1998; 90: 889–905PubMedCrossRef
33.
Karrer S., Bäumler W., Abels C., et al. Long-pulse dye laser for photodynamic therapy: investigations in vitro and in vivo. Las Surg Med 1999; 25: 51–59CrossRef
34.
David L.M. Laser vermilion ablation for actinic cheilitis. J Dermatol Surg Oncol 1985; 7: 520–523
35.
Hohenleutner U., Landthaler M., Hohenleutner S. CO2-Laservaporisation der Cheilitis actinica. Hautarzt 1999; 50: 562–565PubMedCrossRef
36.
Fitzpatrick R.E., Goldman M.P., Ruiz-Esparza J. Clinical advantage of the CO2 laser superpulsed mode: treatment of verruca vulgaris, seborrheic keratoses, lentigines, and actinic cheilitis. J Dermatol Surg Oncol 1994; 20: 449–456PubMed
37.
Stender I.M., Wulf H.C. Photodynamic therapy with 5-aminolevulinic acid in the treatment of actinic cheilitis. Br J Dermatol 1996; 135: 454–456PubMedCrossRef
38.
Horch H.H., Gerlach K.L., Schäfer H.E. CO2 laser surgery of oral premalignant lesions. Int J Oral Maxillofac Surg 1986; 15: 19–24PubMedCrossRef
39.
Chiesa R., Sala L., Costa L., et al. Excision of oral leukoplakias by CO2 laser on an outpatient basis: a useful procedure for prevention and early detection of oral carcinomas. Tumor 1986; 72: 307–312
40.
Landthaler M., Brunner R., Haina D. Nd: YAG laser therapy of an oral verrucous leukoplakia. Dermatologica 1989; 178: 115–117PubMedCrossRef
41.
Schoelch M.L., Sekandari N., Regezi J.A., et al. Laser management of oral leukoplakias: a follow-up study of 70 patients. Laryngoscope 1999; 109: 949–953PubMedCrossRef
42.
Bernstein Z.P., Wilson D., Mang T.S. Pilot study PDT for treatment of AIDS-associated Kaposi sarcoma. Proc Am Soc Clin Oncol 1994; 13: 51
43.
Abels C., Karrer S., Bäumler W., et al. Indocyanine green and laser light for the treatment of AIDS-associated cutaneous Kaposi’s sarcoma. Br J Cancer 1998; 77: 1021–1024PubMedCrossRef
44.
Wheeland R.G., Bailin P.L., Norris M.J. Argon laser photocoagulative therapy of Kaposi’s sarcoma: a clinical and histological evaluation. J Dermatol Surg Oncol 1985; 11: 1180–1185PubMed
45.
Tappero J.W., Grekin R.C., Zanelli G.A., et al. Pulsed-dye laser therapy for cutaneous Kaposi’s sarcoma associated with aquired immunodeficiency syndrome. J Am Acad Dermatol 1992; 27: 526–530PubMedCrossRef
46.
Orten S.S., Waner M., Dinehart S.M., et al. Q-switched neodymium: yttrium-aluminium-garnet laser treatment of lentigo maligna. Otolaryngol Head Neck Surg 1999; 120: 296–302PubMedCrossRef
47.
Arndt K.A. New pigmented macule appearing four years after argon laser treatment of lentigo maligna. J Am Acad Dermatol 1986; 14: 1092PubMedCrossRef
48.
Kauvar A.N.B., Geronemus R.G. Treatment of lentigo maligna with the Q-switched ruby laser. Lasers Surg Med 1995; (Suppl. 7): 48
49.
Lee P.K., Rosenberg C.N., Taso H., et al. Failure of Q-switched ruby laser to eradicate atypical-appearing solar lentigo: report of two cases. J Am Acad Dermatol 1998; 38: 314–317PubMedCrossRef
50.
Kopera D., Hohenleutner U., Stolz W., et al. Ex vivo quality-switched ruby laser irradiation of cutaneous melanocytic lesions: persistence of S-100-, HMB-45 and Masson-positive cells. Dermatology 1997; 194: 344–350PubMedCrossRef
51.
Grob M., Senti G., Dummer R. Diganoseverzögerung bei einem amelanotischen Melanom durch CO2-Laserung. Fallbericht und Diskussion. Schweiz Rundsch Med Prax 1999; 88: 1491–494
52.
Kozlov A.P., Moskalik K.G. Pulsed laser radiation therapy of skin tumors. Cancer 1980; 46: 2172–2178PubMedCrossRef
53.
Hill S., Thomas J.M. Treatment of cutaneous metastases from malignant melanoma using the carbon-dioxide laser. Eur J Surg Oncol 1993; 19: 173–177PubMed
54.
Hill S., Thomas J.M.. Use of the carbon dioxide laser to manage cutaneous metastases from malignant melanoma. Br J Surg 1996; 83: 509–512PubMedCrossRef
55.
Lingam M.K., McKay A.J. Carbon dioxide laser ablation as an alternative treatment for cutaneous metastases form malignant melanoma. Br J Surg 1995; 82: 1346–1348PubMedCrossRef
56.
Karrer S., Abels C., Bäumler W., et al. Photochemotherapie von kutanen Rektumkarzinommetastasen mit Indocyaningrün. Dtsch Med Wochenschr 1997; 122: 1111–1114PubMedCrossRef
57.
Lapes M., Petera J., Jirsa M. Photodynamic therapy of cutaneous metastases of breast cancer after local application of meso-tetra-(para-sulphophenyl)-porphin (TPPS4). J Photochem Photobiol B 1996; 36: 205–207PubMedCrossRef
58.
Kaplan M.J., Somers R.G., Greenberg R.H., et al. Photodynamic therapy in the management of metastatic cutaneous adenocarcinomas: case reports from phase 1/2 studies using tin ethyl etiopurpurin (SnET2). J Surg Oncol 1998; 67: 121–125PubMedCrossRef
59.
Mang T.S., Allison R., Hewson G., et al. A phase II/III clinical study of tin ethyl etiopurpurin (Purlytin)-induced photodynamic therapy for the treatment of recurrent cutaneous metastatic breast cancer. Cancer J Sci Am 1998; 4: 378–384PubMed
Metadata
Title
Role of Lasers and Photodynamic Therapy in the Treatment of Cutaneous Malignancy
Authors
Dr Sigrid Karrer
Rolf-Markus Szeimies
Ulrich Hohenleutner
Michael Landthaler
Publication date
01-08-2001
Publisher
Springer International Publishing
Published in
American Journal of Clinical Dermatology / Issue 4/2001
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI
https://doi.org/10.2165/00128071-200102040-00004

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