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Combining Mohs Surgery and Topical Photodynamic Therapy for Facial Basal Cell Carcinoma

By: Sarah Campen, PharmD
Posted: Monday, October 26, 2020

Combining Mohs surgery with topical photodynamic therapy may prove to be an effective treatment of patients with facial basal cell carcinomas, according to a Chinese study published in the Journal of Cancer Research and Therapeutics. Yuanyuan Wang, MD, of the Army Military Medical University, Chongqing, China, and colleagues reported that the treatment combination reduced the tumor recurrence rate while maintaining the local tissues' relative integrity and appearance.

The study included 86 patients with facial basal cell carcinoma. The lesions were superficial and nodular basal cell carcinoma in 48 and 38 patients, respectively. Most patients (89.5%) were diagnosed with primary tumors, and the remainder (10.5%) had recurrent tumors after undergoing surgeries in other hospitals. Mohs surgery was used to remove the lesions followed by direct suturing, skin flap grafting, or medium thickness–free skin grafting. Next, topical photodynamic therapy—a method used to exploit the high affinity between the photosensitizers and damaged tissues—was performed three times, in 2-week intervals, beginning immediately after suture removal.

No cases of recurrence were observed within 1 year after the combined method; however, one recurrence was recorded at 2 years after the operation, yielding a relapse rate of 1.16%. The original tumor in this patient was located on the left lower eyelid. It could not be completely removed during Mohs surgery, although the skin lesions had disappeared completely after 3 treatments with topical photodynamic therapy. The combination of Mohs surgery and topical photodynamic therapy appeared to be well tolerated and localized to the treatment area; a topical burning sensation and mild pain were the most commonly reported adverse events.

Disclosure: The study authors reported no conflicts of interest.

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