Er: YAG ablative fractional laser-primed photodynamic therapy with methyl aminolevulinate as an alternative treatment option for patients with thin nodular basal cell carcinoma: 12-month follow-up results of a randomized, prospective, comparative trial.

Background Surgical excision is conventionally regarded as the treatment of choice for nodular basal cell carcinoma ( nBCC), and methyl aminolevulinate photodynamic therapy ( MAL- PDT) has relatively low efficacy for nBCC. However, Er: YAG ablative fractional laser ( AFL)-primed MAL- PDT (Er: YAG AFL- PDT) may offer enhanced efficacy for nBCC, especially thin nBCC (thickness ≤2 mm). Objective We compared Er: YAG AFL- PDT with conventional MAL- PDT for thin facial nBCC in Korean patients. Methods Thirty-nine patients (42 lesions) with primary, histologically proven thin nBCCs were randomized to Er: YAG AFL- PDT (single session, n = 20) or conventional MAL- PDT (two sessions, 7 days apart, n = 19). Efficacy, recurrence rate, cosmetic outcomes and safety were assessed 1 week, 3 months and 12 months after the last treatment. Results Three months after the final treatment, overall complete response rates were 84.2% with Er: YAG AFL- PDT and 50% with MAL- PDT ( P = 0.026). The recurrence rate was significantly lower with Er: YAG AFL- PDT (6.3%) than with MAL- PDT (55.6%) at 12 months ( P = 0.006). Er: YAG AFL- PDT and MAL- PDT did not differ significantly with respect to cosmetic outcomes or safety. Conclusions Er: YAG AFL- PDT can be used as an alternative treatment option for patients who have thin nBCC and are not suitable for surgical treatment. [ABSTRACT FROM AUTHOR]