Imiquimod and PDT equivalent for superficial basal cell carcinoma

Jun 1 2012

By MedWire Reporters

Imiquimod cream and photodynamic therapy (PDT) for superficial basal cell carcinoma result in near equivalent rates of tumor-free survival after 1 year of treatment, a review shows.

Interestingly, the review also showed that the effectiveness of PDT might be dependent on the number of cycles used.

"Treatment results after PDT might be optimized by repetitive treatments," write Marieke Roozeboom (Maastricht University Medical Center, the Netherlands) and colleagues in the British Journal of Dermatology.

Superficial basal cell carcinoma is the least aggressive subtype of skin cancer and can be treated with PDT, immunotherapy, local chemotherapeutic cream, and cryotherapy. There is no consensus, however, on the best treatment.

In this review of published studies, Roozeboom and colleagues aimed to determine the recurrence and tumor-free survival rates of patients with superficial basal cell carcinoma treated with frequently used therapies.

Among 28 studies, a complete response to imiquimod and PDT at 12 weeks was observed in 86.2% and 79.0% of treated patients, respectively. The difference in the response to therapy was statistically significant.

The rates of tumor-free survival at 1 year were 87.3% in the imiquimod-treated patients and 84.0% in those who received PDT, a nonsignificant difference.

However, when repetitive PDT treatments were used, the rates of complete response to treatment and tumor-free survival increased, report the investigators.

"Disadvantages of more frequent illuminations (with PDT) will be higher costs and more frequent treatment appointments," write Roozeboom and colleagues.

Based on these findings, a treatment choice between PDT and the use of imiquimod cream should depend on patient preferences and tumor characteristics, they add.

There were too few studies testing 5-fluorouracil, cryotherapy, surgical excision, and other treatments to include them in the analysis.

Head-to-head studies comparing imiquimod and PDT were also not available and there remains a dearth of long-term outcome studies of these treatments, according to researchers.

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