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Basal Cell Carcinoma: Is Combination of Laser Therapy and Optical Coherence Tomography Effective?

By: Joseph Fanelli
Posted: Monday, March 21, 2022

The Nd:YAG laser may be an effective option for treating patients with basal cell carcinoma lesions when it is used in combination with noninvasive diagnostic tools such as optical coherence tomography, according to findings presented in Lasers in Surgery and Medicine. Orit Markowitz, MD, and Moshe Y. Bressler, DO, both of the Icahn School of Medicine at Mount Sinai, New York, reported that using Nd:YAG laser treatment guided by optical coherence tomography was associated with high rates of tumor clearance and low rates of recurrence.

“Treatment success is dependent on lesion size, basal cell carcinoma subtype, and patient immunosuppression status,” the authors concluded.

To determine the efficacy of Nd:YAG lasers in this trial, the investigators applied 1,064-nm Nd:YAG lasers to 119 basal cell carcinoma lesions from 102 patients. Tumor margins were approximated using optical coherence tomography. Lesions were treated every 2 months until no residual tumor remained. The patients were monitored for 1 year following treatment.

The lasers cleared 85 lesions (70.4%) after one treatment. For the remaining lesions that required two or more treatments, the authors found that lesions greater than 5 mm, focal sclerosing subtype, and immunosuppression were all factors for suboptimal responses.

All the lesions demonstrated complete clinical and subclinical tumor clearance 2 months after the final treatment. About 1 year after the last treatment, the authors recorded an overall clinical recurrence rate of 1.7% (two lesions) and a cumulative subclinical recurrence rate of 4.2% (five lesions). After immunosuppressed patients were excluded, the clinical and subclinical recurrence rates for primary basal cell carcinoma were 1% and 2% and 0% and 11.8% for recurrent basal cell carcinoma, respectively.

Disclosure: The authors reported no conflicts of interest.

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