Is the benefit of sequential 5-fluorouracil and daylight photodynamic therapy versus daylight photodynamic therapy alone sustained over time? – 12-month follow-up of a randomized controlled trial

Stine Regin Wiegell*, Gabriella Fredman, Flemming Andersen, Peter Bjerring, Uwe Paasch, Merete Haedersdal

*Corresponding author af dette arbejde

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Abstract

Background
Since recurrences and new AKs commonly are observed after treatment long-term effects of field-directed therapies for AKs are crucial. Thus, we evaluated the 6- and 12-month efficacy and satisfaction of sequential topical 5-fluorouracil (5-FU) and daylight PDT (dPDT) with dPDT alone.
Methods
In a randomized intra-individual study patients with multiple AKs in the face and scalp were treated with 4 % 5-fluorouracil cream twice daily for 7 days on one side of the scalp/face, followed by dPDT on both sides. Lesion clearance rate, lesion recurrence rate and number of new lesions were evaluated at 6- and 12-month after treatment.
Results
58/60 completed 6-month and 55/60 completed 12-month follow-up. Pre-treatment with topical 5-FU improved the long-term efficacy of dPDT, especially for moderately thick AKs, with a lesion clearance of 72 % at 12-month compared to 48 % after dPDT alone (p = 0.017). The recurrence rate at 12-month was 15 % for combination treatment and 20 % for dPDT alone (0.042). Most patients were highly satisfied with both treatments.
Conclusions
Sequential treatment with short-term topical 5-FU followed by dPDT maintained a higher complete lesion clearance than dPDT alone at both 6- and 12-month follow-ups, with fewer new AKs developing after combination therapy.
OriginalsprogEngelsk
Artikelnummer104445
TidsskriftPhotodiagnosis and Photodynamic Therapy
Vol/bind51
Antal sider3
ISSN1572-1000
DOI
StatusUdgivet - 2025

Bibliografisk note

Funding Information:
The work was executed and funded as a part of the Danish Research Center for Skin Cancer, a public-private research partnership between the Private Hospital M\u00F8lholm, Aalborg University Hospital and Copenhagen University Hospital, Bispebjerg. GME Medical provided the MultiLite daylight lamps.

Publisher Copyright:
© 2024

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