| ObjectiveTo determine the cure rate,effective rate,total effective rate,incidence of adverse reactions,course of treatment and recurrence rate of ALA-PDT therapy in the treatment of common skin malignant tumors.To summarize the advantages and disadvantages of ALA-PDT treatment methods and guide clinicians to select and apply the treatment from the aspects of curative effect,adverse reaction,recurrence rate,trauma,cosmetology and patient satisfaction.MethodsCollected the patients in my department,with basal cell carcinoma,squamous cell carcinoma,Bowen's disease or Paget's disease,from 2015~2016.All patients were treated with 3or4 times of ALA-PDT treatment.Observed and analyzed the curative effect,adverse reaction,recurrence rate,trauma,cosmetology and patient satisfaction,and make record.Results1?Curative effect observation 19 cases of basal cell carcinoma,12 cases were cured,6 cases markedly effective,the total efficiency of 94.73%;12 cases of squamous cell carcinoma,4 cases were cured,5 cases markedly effective,the total efficiency of 75%;3 cases of Paget disease,1 cases were cured,2 cases were effective,the total efficiency of 33.33%;3 cases of actinic keratosis were well,the total effective rate of 100%;1 cases of Bowen disease were cured;1 cases of Bowenoid papulosis were effective.2?Adverse reactions 9 patients had adverse reactions,mild burning sensation,pain,blisters,erosion,peripheral pigmentation or decreased,the total incidence was 23.08%.The mild burning sensation in 4 cases,the incidence rate was 10.26%;only 1 cases of pain,the incidence rate was 2.56%;burning with blisters and erosions,peripheral pigmentation in 2 cases,the incidence rate was 5.13%;only around the pigmentation or impairment in 2 cases,the incidence rate was 5.13%.3?Traumatic assessment Pain assessment:1 cases of pain index was 2 points,the rest of the patients are at the rate of 1 points(painless,or mild pain,can be tolerated,does not affect the life and sleep);Functional assessment:All 39 patients were grade III(satisfactory,with no limitation,no impact on life,and no local abnormality).4?Cosmetic effect evaluation In 39 patients,1 patients were grade 1(accounting for 2.56%),the formation of clear brown pigmentation spots on the surface and the edge;35 patients were grade 2(accounting for 89.74%),and most of them had very thin scar or no scar;3 patients were grade 3(accounting for 7.69%),There was no scar and pigmentation.5?Recurrence There were 15 cases of recurrence,including 7 cases of basal cell carcinoma,the recurrence rate was 36.84%;4 cases of squamous cell carcinoma,the recurrence rate was 33.33%;3 cases of Paget disease,the recurrence rate was 100%;1 cases of Bowenoid papulosis,the recurrence rate was 100%;no recurrence of actinic keratosis and Bowen disease.6?Patient satisfaction survey 23 cases had 5 point(very satisfied),accounting for 58.97%;14 cases had 4 point(satisfactory),accounting for 35.90%;2 cases had 3 point(in general),accounting for 5.13%.The overall satisfaction rate was 94.87%.Conclusion1?ALA-PDT therapy can be used in clinical treatment of a variety of skin tumors,including solar keratosis,Bowen disease,skin basal cell carcinoma,squamous cell carcinoma of the skin,some breast Paget disease.2?ALA-PDT alone can not significantly reduce the recurrence of skin tumors.3?ALA-PDT treatment can have mild burning,burning,blisters and erosions,peripheral pigmentation or loss and other adverse reactions,but the occurrence rate is low.4?ALA-PDT therapy is less invasive,good cosmetic effect,high patient satisfaction,less adverse reactions,skin cancer patients for special site of clinical,The utility model is especially suitable for skin tumors patients of special parts,and elderly patients,especially those with multiple chronic diseases,and can not tolerate other traumatic treatment. |
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