Basalzellkarzinome und spinozelluläre Karzinome

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.

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