A review of pain experienced during topical photodynamic therapy--our experience in Dundee.

نویسندگان

  • Sasi Kiran Attili
  • Robert Dawe
  • Sally Ibbotson
چکیده

BACKGROUND Topical photodynamic therapy (PDT) using 5-aminolaevulinic acid (ALA) and its methylated ester, methyl aminolevulinate (MAL) is widely used to treat superficial non-melanoma skin cancer (NMSC). It has been proposed that ALA PDT is more painful than MAL PDT. The aim of this paper was to compare pain scores of MAL PDT with ALA PDT in our patients and to analyse the relationship between various parameters and pain during PDT. METHODS We retrospectively reviewed case notes and electronic records for all patients with superficial NMSC treated with PDT from June 2007 to March 2009. RESULTS On univariate analysis of patients with single lesions only, we observed no association between pain and lesion diameter or pro-drug or dose or diagnosis. Pre-treatment PpIX fluorescence was significantly associated with pain. However on univariate analysis of all patients (whether single or multiple lesions) treated with PDT, MAL was associated with significantly less pain than ALA. When all the recorded variables were taken into account (multivariate analysis), diagnosis, pre-treatment PpIX fluorescence and lesion diameter were associated with pain. CONCLUSIONS Our data lends some support to previous published reports suggesting that the MAL PDT regime is less painful than that for ALA PDT. However, PDT pain is multifactorial and choice of photosensitiser is probably not a major pain determining factor. A prospective randomised study, with the same incubation periods for each pro-drug, is needed to definitively answer the question as to whether or not MAL PDT causes less pain than ALA PDT.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Review of photodynamic therapy in actinic keratosis and basal cell carcinoma

The number of non-melanoma skin cancers is increasing worldwide, and so also the demand for effective treatment modalities. Topical photodynamic therapy (PDT) using aminolaevulinic acid or its methyl ester has recently become good treatment options for actinic keratosis and basal cell carcinoma; especielly when treating large areas and areas with field cancerization. The cure rates are usually ...

متن کامل

Immediate whealing urticaria in red light exposed areas during photodynamic therapy.

One of the recommended first-line treatments for basal cell carcinomas, actinic keratoses and Bowen's disease is photodynamic therapy. Commonly associated side- effects include pain and phototoxicity. Histamine release is a part of this reaction, but whealing urticaria follow noting photodynamic therapy has only been reported by the manufacturer. The aim of this study was to investigate the pre...

متن کامل

Morphine gel 0.3% does not relieve pain during topical photodynamic therapy: a randomized, double-blind, placebo-controlled study.

There is a demand for pain relief during photodynamic therapy. We therefore investigated the efficacy and side-effects of topical morphine gel 0.3% for pain relief during topical photodynamic therapy in a randomized, double-blind, placebo-controlled study. The study involved 28 patients with actinic keratoses or basal cell carcinomas. Each patient was treated with photodynamic therapy after sup...

متن کامل

A Review on Experimental Assessments of Pain Threshold in Healthy Human Subjects

A B S T R A C T There are three types of nerve fibers that are involved in the transmission of pain stimuli: C fibers (slower fibers) for thermal, mechanical and chemical stimuli, A-delta fibers for thermal or mechanical stimuli and A-beta fibers for touch stimuli. Clinically, this is crucial in making an accurate assessment of the pain level experienced by a suffering patient, in indicating th...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Photodiagnosis and photodynamic therapy

دوره 8 1  شماره 

صفحات  -

تاریخ انتشار 2011