Faced with growing difficulties of treating one variety of skin cancer called basal cell carcinoma the senior author Mr Murison elected to treat lesions on the lower leg with the CO2 laser and immediate PDT (Photodynamic Therapy). Initial results reported excellent cosmetic outcomes and effective control of the skin cancer.
In response to requests from patients more sites were treated, and the following is the published results of our treatment of a large series of patients.
One hundred ten patients with a total of 177 lesions mainly on the head and neck were treated with combined therapy using an UltraPulse CO2 laser and PDT using Methyl Aminolevulinate at the same sitting, with repeat PDT one week later.
A total of 177 lesions were diagnosed and treated. Only biopsy-proven BCCs were included in this study. All lesions responded to treatment as assessed by clinical evaluation with regular follow-up. The total recurrence-free rate was 97.1% at a mean follow-up period of 32.2 months.
Recurrences were noted in 5 (2.82%) cases. All recurrences were treated successfully, all but one using repeat laser-PDT. One patient underwent surgical excision. No significant complications were encountered, although mild hypopigmentation was occasionally seen and some discomfort is experienced with PDT.
Combined CO2 laser and PDT have equivalent cure rates to surgery for BCCs. These modalities acting synergistically. This strategy provides cure often with scarless outcomes as illustrated in the following cases: