BCC treatment with laser combination shows promise

Noninvasive, nonscarring treatment of basal cell carcinoma (BCC) could be on the horizon.

A team of Harvard researchers has examined the possibility of combining pulsed dye laser (PDL) and Nd:YAG laser therapy to treat BCC, as opposed to the traditional surgical excision, Mohs surgery, or electrodessication and cautery.

Their study is based on 13 biopsy-proven BCCs that received four combined PDL and Nd:YAG treatments over the course of two to four weeks. None of the cancers examined met the criteria for Mohs surgery. The tumors and a small area of surrounding skin were treated and later excised and evaluated for residual tumor. The primary endpoint of the study was histologic clearance of tumor, while the secondary endpoint was blinded investigator assessment of clinical endpoint and adverse effects.

The authors wrote that BCC are characterized by a tumor-associated microvasculature interwoven throughout the tumor bed. Vascular-specific lasers can target and destroy these abnormal blood vessels - and thus the BCC cells - with minimal damage to surrounding tissue. Previous studies have shown the efficacy of vascular-specific lasers such as pulsed dye and alexandrite lasers in the treatment of BCC, and the new study appears to confirm the efficacy of combined pulsed dye and Nd:YAG vascular-specific laser therapy.

According to study researcher Mathew M. Avram, M.D., director of the MGH Dermatology Laser & Cosmetic Center at Massachusetts General Hospital, Boston, the therapy is most efficacious with certain-size tumors.

“In this and in prior studies, basal cell size less than 1.5 cm was associated with the best improvement,” he tells Dermatology Times. “Side effects were minimal. There was temporary bruising, but no long-term side effects such as pigmentary change or scarring.”

The study was published in the January issue of Lasers in Surgery and Medicine.