Photodynamic therapy for cutaneous squamous cell carcinoma in situ: impact of anatomic location, tumor diameter and incubation time on effectiveness

Background
Photodynamic therapy (PDT) has been reported as a treatment for cutaneous squamous cell carcinoma in situ (SCCis) but there is limited data on the effectiveness of PDT with aminolevulinic acid (ALA-PDT).
Objective
To review the outcomes of SCCis treated with ALA-PDT and examine factors associated with response.
Methods
Retrospective review identified 58 patients with 68 primary SCCis lesions treated with ALA-PDT and blue light illumination. Patient demographics, lesion features, treatment details, clinical response, and subsequent recurrence were extracted from medical record review.
Results
Upon completion of PDT, the initial complete response rate was 77.9% and was not associated with the number of PDT treatments. On multivariate analysis, the factors associated with response were location on the face, tumor diameter <2 centimeters, and longer ALA incubation time. Lesions treated with a maximum incubation time of <3 hours had a 53.3% response compared with 84.9% for longer incubation. Subsequent recurrence of SCCis was noted in 7 of 53 cases (13.2%) at a median time of 11.7 months.
Limitations
This was a retrospective study performed at a single institution without systematic follow-up.
Conclusions
ALA-PDT may be an effective treatment for selected cases of SCCis. Effectiveness is impacted by anatomic location, tumor diameter, and ALA incubation time.

This Dataset is Supplementary Data for the manuscript, "Photodynamic therapy for cutaneous squamous cell carcinoma in situ: impact of anatomic location, tumor diameter and incubation time on effectiveness."
Authors: Nour Kibbi, MD, Yuemei Zhang, MD, MBA, David J. Leffell, MD, and Sean R. Christensen, MD, PhD
Accepted for publication by Journal of the American Academy of Dermatology 2019 (JAAD-D-19-01312R1).

Supplementary Figure 1. Response of SCCis according to number of PDT treatments.
A, Initial complete response for all lesions and according to number of PDT treatments. B, Durable complete response at final follow-up for all lesions and according to number of PDT treatments.

Supplementary Figure 2. Occlusion during PDT incubation period was significantly associated with incubation time.
P value was calculated using the Spearman correlation.

Supplementary Table. Factors associated with recurrence of SCCis after initial complete response.

背景
光动力疗法（PDT）已被报道为治疗原位皮肤鳞状细胞癌（SCCis）的方法，但对于氨基乙酰丙酸（ALA-PDT）光动力疗法有效性的数据却有限。
目标
本研究的目的是回顾ALA-PDT治疗SCCis的疗效，并探讨影响疗效的相关因素。
方法
通过回顾性研究，确定了58名接受ALA-PDT和蓝光照射治疗的68个原位SCCis病变患者。从病历审查中提取了患者的流行病学特征、病变特征、治疗细节、临床反应和后续复发情况。
结果
完成PDT治疗后，初始完全缓解率为77.9%，且与PDT治疗次数无关。多因素分析显示，与疗效相关的因素包括面部位置、肿瘤直径小于2厘米和较长的ALA孵化时间。孵化时间最长小于3小时的病变治疗后的缓解率为53.3%，而较长时间孵化的缓解率为84.9%。在53个病例中，SCCis的后续复发病例为7例（13.2%），中位时间为11.7个月。
局限性
这是一项在单一机构进行的回顾性研究，缺乏系统的随访。
结论
ALA-PDT可能对某些SCCis病例的治疗有效。疗效受解剖位置、肿瘤直径和ALA孵化时间的影响。
本数据集是关于‘光动力疗法在皮肤鳞状细胞癌原位治疗中的影响：解剖位置、肿瘤直径和孵化时间对疗效的影响’的论文的补充数据。
作者：Nour Kibbi，医学博士，Yuemei Zhang，医学博士，MBA，David J. Leffell，医学博士，Sean R. Christensen，医学博士，哲学博士
由美国皮肤病学学会杂志（JAAD）2019年接受发表（JAAD-D-19-01312R1）。
补充图1. SCCis的缓解情况与PDT治疗次数的关系。
A，所有病变的初始完全缓解情况及根据PDT治疗次数的分布。B，最终随访时所有病变的持久完全缓解情况及根据PDT治疗次数的分布。
补充图2. PDT孵化期间的中断与孵化时间显著相关。
P值使用Spearman相关性计算。
补充表。初始完全缓解后SCCis复发的相关因素。