Comparison of the Treatment Outcomes of Photodynamic Therapy and Ingenol Mebutate in Bowen’s Disease: A Retrospective Observational Study
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Bowen’s disease (BD) is treated by multiple treatment modalities. Objective: To assess the effectiveness of photodynamic therapy (PDT) and ingenol mebutate (IMB) in treating BD and determine the factors affecting the treatment outcome. Methods: Patients with histologically confirmed BD from January 1, 2006, to December 31, 2017, were identified from the database of CHA Bundang Medical Center. Those treated with PDT or IMB were included. Patient, tumor characteristics, and treatment response data were retrospectively collected from the database. Results: Overall, 44 and 24 BD were treated with PDT and IMB, respectively. Mean time to the first follow-up visit was 1.2 (0.5∼4) months. Mean follow-up duration was 7.6 (1∼36) months. The mean number of treatment sessions for PDT is 2 sessions (1∼5), while that of IMB was equally 1 session. The complete response rates at the first follow-up visit were 66.7% and 53.0% and recurrence rates were 10.3% and 15.3% for PDT and IMB, respectively. However, the treatment outcome and recurrence rate between both treatment modalities were not significantly different (p=0.349 and p=0.993, respectively). In factor analysis, the complete response rate significantly decreased with older patients in IMB (p=0.012). Adverse events, occurred in 20.5% and 45.8% of patients treated with PDT and IMB, respectively. Conclusion: PDT and IMB are effective noninvasive treatment modalities for BD. However, PDT is a safer treatment modality, considering its fewer adverse events. Particularly, with age being a factor that reduces IMB outcome, in older patients, PDT can be considered as preferred treatments over IMB.
Abstract
Bowen’s disease (BD) is treated by multiple treatment modalities. Objective: To assess the effectiveness of photodynamic therapy (PDT) and ingenol mebutate (IMB) in treating BD and determine the factors affecting the treatment outcome. Methods: Patients with histologically confirmed BD from January 1, 2006, to December 31, 2017, were identified from the database of CHA Bundang Medical Center. Those treated with PDT or IMB were included. Patient, tumor characteristics, and treatment response data were retrospectively collected from the database. Results: Overall, 44 and 24 BD were treated with PDT and IMB, respectively. Mean time to the first follow-up visit was 1.2 (0.5∼4) months. Mean follow-up duration was 7.6 (1∼36) months. The mean number of treatment sessions for PDT is 2 sessions (1∼5), while that of IMB was equally 1 session. The complete response rates at the first follow-up visit were 66.7% and 53.0% and recurrence rates were 10.3% and 15.3% for PDT and IMB, respectively. However, the treatment outcome and recurrence rate between both treatment modalities were not significantly different (p=0.349 and p=0.993, respectively). In factor analysis, the complete response rate significantly decreased with older patients in IMB (p=0.012). Adverse events, occurred in 20.5% and 45.8% of patients treated with PDT and IMB, respectively. Conclusion: PDT and IMB are effective noninvasive treatment modalities for BD. However, PDT is a safer treatment modality, considering its fewer adverse events. Particularly, with age being a factor that reduces IMB outcome, in older patients, PDT can be considered as preferred treatments over IMB.
참고문헌 (35)
- 박민수, "보웬병의 임상 및 병리조직학적 고찰", 대한피부과학회지, 41(9), pp.1157~1162 (2003), 대한피부과학회
- 최희봉, "보웬병의 임상 및 병리조직학적 연구", 대한피부과학회지, 44(9), pp.1058~1064 (2006), 대한피부과학회
- Cassarino DS, "Cutaneous squamous cell carcinoma : a comprehensive clinicopathologic classification--part two", J Cutan Pathol, 33, pp.261~279 (2006)
- Cox NH, "Guidelines for management of Bowen’s disease : 2006 update", Br J Dermatol, 156, pp.11~21 (2007)
- Bonerandi JJ, "Guidelines for the diagnosis and treatment of cutaneous squamous cell carcinoma and precursor lesions", J Eur Acad Dermatol Venereol, 25(Suppl 5), pp.1~51 (2011)
- "NCCN clinical practice guidelines in oncology (NCCN GuidelinesⓇ). Basal cell and squamous cell skin cancers" (2012)[URL]
- Truchuelo M, "Effectiveness of photodynamic therapy in Bowen’s disease : an observational and descriptive study in 51 lesions", J Eur Acad Dermatol Venereol, 26, pp.868~874 (2012)
- Bath-Hextall FJ, "Interventions for cutaneous Bowen’s disease", Cochrane Database Syst Rev, 6, pp.CD007281~ (2013)
- Morton CA, "Guidelines for topical photodynamic therapy: update", Br J Dermatol, 159, pp.1245~1266 (2008)
- 김윤전, "보웬병에서 국소 광역동요법의 치료 효과", 대한피부과학회지, 45(3), pp.237~241 (2007), 대한피부과학회
- Genovese G, "Daylight methyl-aminolevulinate photodynamic therapy versus ingenol mebutate for the treatment of actinic keratoses : an intraindividual comparative analysis", Dermatol Ther, 29, pp.191~196 (2016)
- Moggio E, "A randomized split-face clinical trial analyzing daylight photodynamic therapy with methyl aminolaevulinate vs ingenol mebutate gel for the treatment of multiple actinic keratoses of the face and the scalp", Photodiagnosis Photodyn Ther, 16, pp.161~165 (2016)
- Zane C, "A randomized split-face clinical trial of photodynamic therapy with methyl aminolevulinate versus ingenol mebutate gel for the treatment of multiple actinic keratoses of the face and scalp", Dermatol, 232, pp.472~477 (2016)
- Shimizu I, "Treatment of squamous cell carcinoma in situ : a review", Dermatol Surg, 37, pp.1394~1411 (2011)
- Varma S, "Bowen’s disease, solar keratoses and superficial basal cell carcinomas treated by photodynamic therapy using a large-field incoherent light source", Br J Dermatol, 144, pp.567~574 (2001)
- Morton CA, "Photodynamic therapy for large or multiple patches of Bowen disease and basal cell carcinoma", Arch Dermatol, 137, pp.319~324 (2001)
- Calin MA, "Photosensitizers and light sources for photodynamic therapy of the Bowen’s disease", Arch Dermatol Res, 303, pp.145~151 (2011)
- Mainetti C, "Successful treatment of relapsing Bowen’s disease with ingenol mebutate : the use of dermoscopy to monitor the therapeutic response", Dermatol, 232(Suppl 1), pp.9~13 (2016)
- Salleras Redonnet M, "Ingenol mebutate gel for the treatment of Bowen’s disease : a case report of three patients", Dermatol Ther, 29, pp.236~239 (2016)
- Lee JH, "Successful treatment of Bowen’s disease with ingenol mebutate 0.05% gel", J Dermatol, 42, pp.920~921 (2015)
- Mohanna MT, "Bowenoid actinic keratosis and Bowen’s disease treated successfully with ingenol mebutate", Dermatol, 232(Suppl 1), pp.14~16 (2016)
- Alkhalaf A, "Ingenol mebutate 150 mg as physician-directed treatment of Bowen’s disease under occlusion", Dermatol, 232(Suppl 1), pp.17~19 (2016)
- Braun SA, "Successful treatment of Bowen disease with ingenol mebutate", Hautarzt, 65, pp.848~850 (2014)
- Lee DW, "Clinical experience of ingenol mebutate gel for the treatment of Bowen’s disease", J Dermatol, 45, pp.425~430 (2018)
- Morton C, "Comparison of topical methyl aminolevulinate photodynamic therapy with cryotherapy or fluorouracil for treatment of squamous cell carcinoma in situ : results of a multicenter randomized trial", Arch Dermatol, 142, pp.729~735 (2006)
- Salim A, "Randomized comparison of photodynamic therapy with topical 5-fluorouracil in Bowen’s disease", Br J Dermatol, 148, pp.539~543 (2003)
- Montecino-Rodriguez E, "Causes, consequences, and reversal of immune system aging", J Clin Invest, 123, pp.958~965 (2013)
- Tyrrell JS, "Comparison of protoporphyrin IX accumulation and destruction during methylaminolevulinate photodynamic therapy of skin tumours located at acral and nonacral sites", Br J Dermatol, 164, pp.1362~1368 (2011)
- Li Q, "Tumor thickness predicts long-term complete response of facial basal cell carcinomas in Asian skin types iv", v treated with methyl aminolaevulinate photodynamic therapy, 2011, pp.29, 501~507
- Morton CA, "Photodynamic therapy for basal cell carcinoma : effect of tumor thickness and duration of photosensitizer application on response", Arch Dermatol, 134, pp.248~249 (1998)
- Calzavara-Pinton PG, "Methylaminolaevulinatebased photodynamic therapy of Bowen’s disease and squamous cell carcinoma", Br J Dermatol, 159, pp.137~144 (2008)
- Mosterd K, "Fractionated 5-aminolaevulinic acid-photodynamic therapy vs. surgical excision in the treatment of nodular basal cell carcinoma: results of a randomized controlled trial", Br J Dermatol, 159, pp.864~870 (2008)
- Ozog DM, "Photodynamic therapy : a clinical consensus guide", Dermatol Surg, 42, pp.804~827 (2016)
- Bay C, "Comparison of physical pretreatment regimens to enhance protoporphyrin IX uptake in photodynamic therapy : a randomized clinical trial", JAMA Dermatol, 153, pp.270~278 (2017)
- Erlendsson AM, "Ablative fractional laser alters biodistribution of ingenol mebutate in the skin", Arch Dermatol Res, 307, pp.515~522 (2015)