Aktuelle Dermatologie 2005; 31(5): 211-216
DOI: 10.1055/s-2005-861108
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Basalzellkarzinome und spinozelluläre Karzinome

Basal Cell and Squamous Cell CarcinomasC.  Beier1 , R.  Kaufmann1
  • 1Zentrum der Dermatologie und Venerologie, Klinikum der J. W. Goethe-Universität Frankfurt/M.
Further Information

Publication History

Publication Date:
25 May 2005 (online)

Zusammenfassung

Mikroskopisch-kontrollierte Chirurgie stellt nach wie vor den Goldstandard in der Behandlung von Basalzellkarzinomen und spinozellulären Karzinomen dar. Die topische photodynamische Therapie oberflächlicher und kleinpapulöser Basalzellkarzinome repräsentiert, neben den bereits bestehenden Modalitäten, eine komplementäre Option und bietet darüber hinaus überlegene kosmetische Resultate und einfache Handhabung. Der gegenwärtige behördliche Zulassungsstatus bedingt im Routinegebrauch die Anwendung des ALA-Methylesters (Metvix®), wie es gemäß der internationalen Multicenterstudien bezüglich Behandlungsintervallen und Bestrahlungsparametern empfohlen wird. Die photodynamische Therapie von spinozellulären Karzinomen sollte wegen der schlechten Ansprechraten und fehlender Zulassung in der Dermatologie spezialisierten Zentren vorbehalten bleiben.

Abstract

Micrographic controlled surgery remains to be the gold standard in the treatment of basal and squamous cell carcinomas. Topical photodynamic therapy of superficial and small papular basal cell carcinomas represents a complementary procedure to the existing treatment modalities and in addition it offers superior cosmetic results and uncomplicated practicability.

The present situation concerning the official approval of the authorities implicates the routine use of the sensitizer ALA-methylester (Metvix®) as it is recommended by investigators of international multi-centre studies regarding treatment intervals and radiation parameters. Photodynamic therapy of invasive squamous cell carcinomas should be restricted to specialized centres because of unsatisfactory remission rates and lack of approval in the dermatologic field.

Literatur

  • 1 Breuninger H, Garbe H C. Basalzellkarzinom der Haut. Plattenepithelkarzinom der Haut einschließlich des Unterlippenrotes und der Augenlider. In: Korting HC, Callies R, Reusch M, Schlaeger M, Sterry W (Hrsg.) Dermatologische Qualitätssicherung. Leitlinien und Empfehlungen. München; Zuckschwerdt 2003
  • 2 Hermanek P, Heuson D E, Hutter R VP, Sobin L H. UICC (International Union against cancer), TNM Supplement. Berlin; Springer 1993
  • 3 Lambert D R, Siegle R J. Skin cancer: a review with consideration of treatment options including Mohs micrographic surgery.  Ohio Med. 1990;  86 745-747
  • 4 De Silva S P, Dellon A L. Recurrence rate of positive margin basal cell carcinoma: results of a five-year prospective study.  J Surg Oncol. 1985;  28 72-74
  • 5 Richmond J D, Davie R M. The significance of incomplete excision in patients with basal cell carcinoma.  Br J Plast Surg. 1987;  40 63-67
  • 6 Rowe D E. Comparison of treatment modalities for basal cell carcinoma.  Clinics Dermatol. 1995;  13 617-620
  • 7 Fleming I D, Amonette R, Monaghan T, Fleming M D. Principles of management of basal and squamous cell carcinoma of the skin.  Cancer. 1995;  75 699-704
  • 8 Shimm D S, Wilder R B. Radiation therapy for squamous cell carcinoma of the skin.  Am J Clin Oncol. 1991;  14 383-386
  • 9 Reymann F. Treatment of basal cell carcinoma of the skin with 5-fluorouracil ointment. A 10-year follow-up study.  Dermatologica. 1979;  158 368-372
  • 10 Rowe D E, Carroll R J, Day C L, Jr. Long term recurrence rates in previously untreated (primary) basal cell carcinoma: implications for patients follow-up.  J Dermatol Surg Oncol. 1989;  15 315-328
  • 11 Olbricht S M. Treatment of malignant cutaneous tumors.  Dermatol Plastic Surg. 1993;  20 167-180
  • 12 von Tappeiner H, Jesionek A. Therapeutische Versuche mit fluoreszierenden Stoffen.  Münchner Med Wochenschr. 1903;  50 2042-2044
  • 13 Dougherty T J, Kaufman J E, Goldfarb A, Weishaupt K R, Boyle D G, Mittleman A. Photoradiation therapy for the treatment of malignant tumors.  Cancer Res. 1978;  38 2628-2635
  • 14 Dougherty T J. Photoradiation therapy for cutaneous and subcutaneous malignancies.  J Invest Dermatol. 1981;  77 122-124
  • 15 Feyh J. Photodynamic treatment for cancers of the head and neck.  J Photochem Photobiol B. 1996;  36(2) 175-177
  • 16 Kübler A C, de Carpentier J, Hopper C, Leonard A G, Putnam G. Treatment of squamous cell carcinoma of the lip using Foscan-mediated photodynamic therapy.  Int J Oral Maxillofac Surg. 2001;  30 504-509
  • 17 Tanaka H, Hashimoto K, Yamada I, Masumoto K, Oshawa T, Mutsuhiko M, Hirano T. Interstitial photodynamic therapy with rotating and reciprocating optical fibers.  Cancer. 2001;  91 1791-1796
  • 18 Kennedy J C, Pottier R H, Pross D C. Photodynamic therapy with endogenous protoporphyrin IX: basic principles and present clinical experience.  J Photochem Photobiol B. 1990;  6 143-148
  • 19 Soler A M, Warloe T, Tausjo J, BernerA . Photodynamic therapy by topical aminolevulinic acid, dimethylsulphoxide and curettage in nodular basal cell carcinoma: a one-year follow-up study.  Acta Derm Venereol. 1999;  79 204-206
  • 20 Harth Y, Hirshowitz B, Kaplan B. Modified topical photodynamic therapy of superficial skin tumors, utilizing aminolevulinic acid, penetration enhancers, red light, and hyperthermia.  Dermatol Surg. 1998;  24 723-726
  • 21 Peng Q, Warloe T, Moan J, Heyerdahl H, Steen H B, Nesland J M, Giercksky K E. Distribution of 5-aminolevulinic acid-induced porphyrins in noduloulcerative basal cell carcinoma.  Photochem Photobiol. 1995;  62 906-913
  • 22 Fijan S, Hönigsmann H, Ortel B. Photodynamic therapy of epithelial skin tumours using delta-aminolaevulinic acid and desferrioxamine.  Br J Dermatol. 1995;  133 282-288
  • 23 Fritsch C, Homey B, Stahl W, Lehmann P, Ruzicka T, Sies H. Preferential relative porphyrin enrichment in solar keratoses upon topical application of 5-aminolevulinic acid methylester.  Photochem Photobiol. 1998;  68(2) 218-221
  • 24 Peng Q, Moan J, Warloe T, Iani V, Steen H B, Bjorseth A, Nesland J M. Build-up of esterified aminolevulinic acid derivative induced porphyrin fluorescence in normal mouse skin.  Journal of Photobiology B: Biology. 1996;  34 95-96
  • 25 Basset-Seguin N, Bachmann I, Pavel S. A dose-finding study of photodynamic therapy (PDT) with Metvix™ in patients with basal cell carcinoma (BCC).  J Eur Acad Dermatol Venereol. 2000;  14 (Suppl 1) 39
  • 26 Horn M, Larkö O, Wulf H C. Photodynamic therapy (PDT) with Metvixtrade cream 160 mg/g in patients with basal cell carcinoma (BCC) unsuitable to conventional therapy. Presented at the Society for Investigative Dermatology. Washington DC; 2001
  • 27 Peng Q, Warloe T, Berg K, Moan J, Kongshaug M, Giercksky K E, Nesland J M. 5-aminolevulinic acid-based photodynamic therapy.  Cancer. 1997;  79 2282-2308
  • 28 Fink-Puches R, Soyer H P, Hofer A, Kerl H, Wolf P. Long-term follow-up and histological changes of superficial nonmelanoma skin cancers treated with topical delta-aminolevulinic acid photodynamic therapy.  Arch Dermatol. 1998;  134 821-826
  • 29 Martin A, Tope W D, Grevelink J M. Lack of selectivity of protoporphyrin IX fluorescence for basal cell carcinoma after topical application of delta-aminolevulinic acid: implications for photodynamic treatment.  Arch Dermatol Res. 1995;  287 665-674
  • 30 Lui H, Salasche S, Kollias N, Wimberly J, Flotte T, Mc Lean D, Anderson R. Photodynamic therapy of nonmelanoma skin cancer with topical aminolevulinic acid: a clinical and histologic study.  Arch Dermatol. 1995;  131 737-738
  • 31 Cairnduff F, Stringer M R, Hudson E J, Ash D V, Brown S B. Superficial photodynamic therapy with 5-aminolevulinic acid superficial primary and secondary skin cancer.  Br J Cancer. 1994;  69 605-608
  • 32 Svanberg K, Andersson T, Killander D, Wang I, Stenram U, Andersson-Engels S, Berg R, Johansson J, Svanberg S. Photodynamic therapy of non-melanoma malignant tumours of the skin using topical delta-aminolevulinic acid sensitization and laser irradiation.  Br J Dermatol. 1994;  30 743-751
  • 33 Kennedy J C, Pottier R H. Endogenous protoporphyrin IX, a clinically useful photosensitizer for photodynamic therapy.  J Photochem Photobiol B. 1992;  14 275-292
  • 34 Jiabi W, Menglin G, Shijun W, Mianjing W. Photodynamic therapy for 50 patients with skin cancers or precancerous lesions.  Chin Med Sci J. 1991;  6 163-165
  • 35 Fritsch C, Goerz G, Ruzicka T. Photodynamic therapy in dermatology.  Arch Dermatol. 1998;  134 207-214
  • 36 Morton C A, Whitehurst C, Mc Coll J H, Moore J V, Mac Kie R M. Photodynamic therapy for large or multiple patches of Bowen disease and basal cell carcinoma.  Arch Dermatol. 2001;  137 319-324
  • 37 Wolf P, Rieger E, Kerl H. Topical photodynamic therapy with endogenous porphyrins after application of 5-aminolevulinic acid.  J Am Acad Dermatol. 1993;  28 17-21
  • 38 Dijkstra A T, Majoie I M, van Dongen J W, van Weelden H, van Vloten W A. Photodynamic therapy with violet light and topical 5-aminolevulinic acid in the treatment of actinic keratosis, Bowen's disease and basal cell carcinoma.  J Eur Acad Dermatol Venereol. 2001;  15 550-554
  • 39 Santoro O, Bandieramonte E, Melloni E, Marchesini R, Zunino F, Lepera P, De Palo G. Photodynamic therapy by topical meso-tetraphenylporphinsulfonate tetrasodium salt administration in superficial basal cell carcinomas.  Cancer Res. 1990;  50 4501-4503
  • 40 Pennington D G, Waner M, Knox A. Photodynamic therapy for multiple skin cancers.  Plast Reconstr Surg. 1988;  82 1067-1071
  • 41 Warloe T, Peng Q, Moan J, Qvist H L, Giercksky K E. Photochemotherapy of multiple basal cell carcinoma with endogenous porphyrins induced by topical application of 5-aminolevulinic acid. In: Spinelli P, Dal Fante M, Marchesini R (Eds.) Photodynamic therapy and biomedical lasers. Amsterdam; Elsevier Science Publishers BV 1992

Dr. med. Christian Beier

Klinikum der J. W. Goethe-Universität Frankfurt/M., Zentrum der Dermatologie und Venerologie

Theodor-Stern-Kai 7 · 60590 Frankfurt/M

Email: christian.beier@kgu.de

    >