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Present and future perspectives of photodynamic therapy for cutaneous squamous cell carcinoma

DOI:10.1016/j.jaad.2018.10.042 期刊:Journal of the American Academy of Dermatology 出版年份:2018 更新时间:2025-09-19 17:15:36
摘要: Cutaneous squamous cell carcinoma (SCC) is the second most common skin cancer. Surgery remains the main stay of treatment, but some patients are not eligible for surgery and, more importantly, lesions at critical sites need nonsurgical approaches for tissue preservation. In this context, photodynamic therapy (PDT) has been extensively studied as noninvasive or minimally invasive treatment, and studies have shown promising results in terms of safety, efficacy, and cosmetic outcome. Also, studies have proposed different mechanism for its efficacy. However, human studies demonstrating its efficacy are limited in terms of sample size and tumor depth of invasion. Good results are mainly seen in case reports of microinvasive SCC, which is defined as SCC limited to papillary dermis. This inadequacy is due to inadequate penetration of topically applied photosensitizers through keratinized tumor surfaces. To overcome these hurdles, pretreatment with lasers or microneedles and encapsulation of photosensitizers into nanoparticles have been tried. Hence, the present article will discuss studies that have demonstrated the efficacy and safety of PDT for cutaneous SCC, studies that have postulated the mechanism of action of PDT, agents that have been used as PDT enhancers, and finally, the recent use of adjuvant therapy in combination with PDT.
作者: Uma Keyal,Anil Kumar Bhatta,Guolong Zhang,Xiu Li Wang
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To discuss the efficacy, safety, mechanisms, enhancers, and adjuvant therapies of photodynamic therapy for cutaneous squamous cell carcinoma, addressing its limitations and future perspectives.

PDT shows promise as a noninvasive treatment for cSCC, especially with enhancements like pretreatment methods, intralesional injection, nanoparticles, and adjuvants. It offers good cosmetic outcomes and safety but is currently recommended only for in situ lesions. Future research should focus on optimizing protocols, conducting larger human studies, and exploring combinations with other therapies to expand its application to invasive SCC.

Human studies are limited in sample size and tumor depth; topical PDT has inadequate penetration for invasive SCC; systemic photosensitivity with intravenous photosensitizers; need for more comparative studies and long-term follow-up; nanomedicine applications are still in early stages with limited clinical data.

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