联合氨基酮戊酸光动力疗法治疗老年颜面部基底细胞癌的疗效及安全性回顾分析  

Efficacy and safety of combination therapy with aminolevulinic acid photodynamic therapy in the treatment of facial basal cell carcinoma in the elderly:a retrospective analysis

作　　者：廖彩荷 王佩茹 吴明顺 孙晓飞 张国龙[1] 王秀丽[1] Liao Caihe;Wang Peiru;Wu Mingshun;Sun Xiaofei;Zhang Guolong;Wang Xiuli(Shanghai Skin Disease Hospital,Institute of Photomedicine,Tongji University School of Medicine,Shanghai 200443,China)

机构地区：[1]上海市皮肤病医院,同济大学医学院光医学研究所,上海200443

出　　处：《中华皮肤科杂志》2025年第1期34-39,共6页Chinese Journal of Dermatology

基　　金：国家重点研发计划(2022YFC2504700、2022YFC2504705、2022YFC2504701);上海申康医院发展中心第二轮《促进市级医院临床技能与临床创新三年行动计划》研究型医师创新转化能力培训项目(SHDC2022CRT017)。

摘　　要：目的探讨不同联合方式的氨基酮戊酸光动力疗法(ALA-PDT)治疗老年颜面部基底细胞癌的临床疗效及安全性。方法回顾性收集2020年8月至2023年10月就诊于上海市皮肤病医院的颜面部基底细胞癌老年患者131例的临床资料,根据皮损深度分别接受刮勺刮除术(41例)、CO_(2)激光治疗(35例)和窄缘切除旷置手术(55例)的强化预处理,所有患者联合ALA-PDT治疗。随访时间6~39(17.7±9.0)个月,评估各组的疗效及不良反应。结果刮除术+ALA-PDT治疗组、CO_(2)激光+ALA-PDT治疗组和窄缘切除旷置手术+ALA-PDT治疗组总缓解率分别为100%(41/41)、100%(35/35)和96.4%(53/55)。患者接受ALA-PDT治疗时有轻度疼痛、局部红肿等暂时性反应,均能完全耐受,未见创面感染、愈合困难等现象。除了窄缘切除旷置手术+ALA-PDT治疗组3例鼻部和鼻唇沟基底细胞癌治疗后形成瘢痕,其余患者颜面部保留良好外观。结论ALA-PDT联合刮除术、CO_(2)激光或窄缘切除旷置手术是PDT在不同深度基底细胞癌的初探治疗,疗效肯定且创伤小,为老年颜面部基底细胞癌提供了有效的治疗方法。Objective To investigate the clinical efficacy and safety of different combination therapies with aminolevulinic acid photodynamic therapy(ALA-PDT)in the treatment of facial basal cell carcinoma in the elderly.Methods A retrospective analysis was conducted on 131 elderly patients with facial basal cell carcinoma who visited Shanghai Skin Disease Hospital from August 2020 to October 2023.According to the depth of the lesions,the patients were divided into 3 groups to receive intensive pretreatment with curettage(41 cases),CO_(2)laser therapy(35 cases),and narrow-margin excision surgery without sutures(55 cases)respectively,all followed by ALA-PDT.During the follow-up period of 17.7±9.0 months,the efficacy was evaluated and adverse reactions were recorded in each group.Results The total remission rates were 100%,100%,and 96.4%in the curettage+ALA-PDT group,CO_(2)laser+ALA-PDT group,and narrow-margin excision surgery without sutures+ALA-PDT group,respectively.The patients experienced mild pain and local erythematous swelling during ALA-PDT treatment,which were temporary and fully tolerable,and no wound infections or difficulties in healing were observed.After treatment,scar formation was observed in 3 cases of basal cell carcinoma on the nose and nasolabial folds in the narrow-margin excision surgery without sutures+ALA-PDT group,but the rest of the patients retained a good facial appearance.Conclusions In this preliminary exploration study on PDT for basal cell carcinoma of different depths,ALA-PDT combined with curettage,CO_(2)laser or narrow-margin excision surgery without sutures all exhibited definite efficacy and minimal damage,providing effective treatment options for facial basal cell carcinoma in the elderly.

关 键 词：癌 基底细胞 光化学疗法 老年人 面部 新辅助治疗 

分 类 号：R739.5[医药卫生—肿瘤]