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Open AccessArticle

Regression Analysis of Protoporphyrin IX Measurements Obtained During Dermatological Photodynamic Therapy

European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UK
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Cancers 2019, 11(1), 72; https://doi.org/10.3390/cancers11010072
Received: 22 November 2018 / Revised: 4 January 2019 / Accepted: 7 January 2019 / Published: 10 January 2019
Photodynamic therapy (PDT) is a light activated drug therapy that can be used to treat a number of dermatological cancers and precancers. Improvement of efficacy is required to widen its application. Clinical protoporphyrin IX (PpIX) fluorescence data were obtained using a pre-validated, non-invasive imaging system during routine methyl aminolevulinate (MAL)-PDT treatment of 172 patients with licensed dermatological indications (37.2% actinic keratosis, 27.3% superficial basal cell carcinoma and 35.5% Bowen’s disease). Linear and logistic regressions were employed to model any relationships between variables that may have affected PpIX accumulation and/or PpIX photobleaching during irradiation and thus clinical outcome at three months. Patient age was found to be associated with lower PpIX accumulation/photobleaching, however only a reduction in PpIX photobleaching appeared to consistently adversely affect treatment efficacy. Clinical clearance was reduced in lesions located on the limbs, hands and feet with lower PpIX accumulation and subsequent photobleaching adversely affecting the outcome achieved. If air cooling pain relief was employed during light irradiation, PpIX photobleaching was lower and this resulted in an approximate three-fold reduction in the likelihood of achieving clinical clearance. PpIX photobleaching during the first treatment was concluded to be an excellent predictor of clinical outcome across all lesion types. View Full-Text
Keywords: aminolevulinic acid (ALA; Ameluz); dermatology; fluorescence; imaging; methyl aminolevulinate (MAL; Metvix); non-melanoma skin cancer (NMSC); photobleaching; photodynamic therapy (PDT); protoporphyrin IX (PpIX) aminolevulinic acid (ALA; Ameluz); dermatology; fluorescence; imaging; methyl aminolevulinate (MAL; Metvix); non-melanoma skin cancer (NMSC); photobleaching; photodynamic therapy (PDT); protoporphyrin IX (PpIX)
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Tyrrell, J.; Paterson, C.; Curnow, A. Regression Analysis of Protoporphyrin IX Measurements Obtained During Dermatological Photodynamic Therapy. Cancers 2019, 11, 72.

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