The use of Laser technologies in the treatment of Basal cell carcinoma as a substitute for conventional surgery
O uso das tecnologias a Laser no tratamento do carcinoma basocelular como substituto à cirurgia convencional
Palavras-chave:
Non-melanoma skin cancer, Basal cell carcinoma, Laser therapy, Nonsurgical treatment, Skin cancerResumo
Skin cancer is the most prevalent malignancy in the world population. Current prospective studies show promising results from the treatment of basal cell carcinoma (BCC) using the Nd:YAG laser. This study evaluated the efficacy and safety of treating BCC with laser therapy. Retrospective, observational and cross-sectional study, compared 2 groups of patients; G1: 24 patients underwent conventional surgery and G2: 27 patients underwent laser therapy with long-pulse Nd:YAG 1064nm. Clinical, histopathological and photographic records were used. Study approved by the institution’s ethics and research committee. All patients treated with the Nd:YAG Laser showed clinical and histological cure in just 1 session, using a 6mm spot, fluence of 100-120J/cm2, pulse duration of 10ms. The safety of laser therapy was demonstrated by the low occurrence of adverse effects. The scars in Groups G1 and G2 had an appearance close to normal skin. The results of this study support randomized and controlled clinical trials for the use of laser therapy in patients with skin tumors, avoiding longer surgical times than conventional surgery, and allowing the patient to return to their usual activities sooner.
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Referências
SHARON E, SNAST I, LAPIDOTH M, KAFTORY R, MIMOUNI D, HODAK E, LEVI A. Laser Treatment for Non-Melanoma Skin Cancer: A Systematic Review and Meta-Analysis. Am J Clin Dermatol. 2021 Jan;22(1):25-38. https://doi.org/10.1007/s40257-020-00562-8.
SANTOS MO, LIMA FCS, MARTINS LFL, OLIVEIRA JFP, ALMEIDA LMA, CANCELA MC. Estimativa de Incidência de Câncer no Brasil, 2023-2025. Revista Brasileira de Cancerologia 2023; 69(1): e-213700. https://doi.org/10.32635/2176-9745.RBC.2023v69n1.3700.
LENZI TCR, REIS CMS, NOVAES MRCG. Epidemiological profile of elderly patients with non-melanoma skin cancer seen at the dermatology outpatient clinic of a public hospital. An Bras Dermatol. 2017 Nov-Dec; 92(6): 882–884. https://doi.org/10.1590/abd1806-4841.20175701.
NCCN GUIDELINES FOR PATIENTS. National Comprehensive Cancer Network Foundation, 2023. Disponível em : https://www.nccn.org/patients/guidelines/content/PDF/basal-cell-patient-guideline.pdf . Acesso em: 12 Abril 2023.
KIM, John Y.s.; KOZLOW, Jeffrey H.; MITTAL, Bharat; MOYER, Jeffrey; OLENCKI, Thomas; RODGERS, Phillip; BICHAKJIAN, Christopher; ARMSTRONG, April; BAUM, Christian; BORDEAUX, Jeremy S. Guidelines of care for the management of basal cell carcinoma. Journal Of The American Academy Of Dermatology, [S.L.], v. 78, n. 3, p. 540- 559, mar. 2018. Elsevier BV. https://doi.org/10.1016/j.jaad.2017.10.006
MARKOWITZ O, BRESSLER MY. Combining Nd:YAG laser with optical coherence tomography for nonsurgical treatment of basal cell carcinoma. Lasers Surg Med. 2022 Jan;54(1):105-112. https://doi.org/10.1002/lsm.23455
JALIAN HR, AVRAM MM, STANKIEWICZ KJ, SHOFNER JD, TANNOUS Z. Combined 585 nm pulsed-dye and 1,064 nm Nd:YAG lasers for the treatment of basal cell carcinoma. Lasers Surg Med. 2014 Jan;46(1):1-7. https://doi.org/10.1002/lsm.22201
IBRAHIMI OA, SAKAMOTO FH, TANNOUS Z, ANDERSON RR. 755 nm alexandrite laser for the reduction of tumor burden in basal cell Nevus syndrome. Lasers Surg Med. 2011 Feb;43(2):68-71. https://doi.org/10.1002/lsm.20953
SALAVASTRU C, TIPLICA GS, FRITZ K. Laser treatment of basal cell carcinoma. Hautarzt. 2018 Jan;69(1):10-16. https://doi.org/10.1007/s00105-017-4092-3
SOLEYMANI T, ABROUK M, KELLY KM. An Analysis of Laser Therapy for the Treatment of Nonmelanoma Skin Cancer. Dermatol Surg. 2017 May;43(5):615-624. https://doi.org/10.1097/dss.0000000000001048
CHOUDHARY S, TANG J, ELSAIE ML, NOURI K. Lasers in the treatment of nonmelanoma skin cancer. Dermatol Surg. 2011 Apr;37(4):409-25. https://doi.org/10.1111/j.1524-4725.2011.01928.x
KAUVAR AN, CRONIN T JR, ROENIGK R, HRUZA G, BENNETT R. Consensus for nonmelanoma skin cancer treatment: basal cell carcinoma, including a cost analysis of treatment methods. Dermatol Surg. 2015 May;41(5):550-71. https://doi.org/10.1097/dss.0000000000000296
AHLUWALIA J, AVRAM MM, ORTIZ AE. Outcomes of long-pulsed 1064 nm Nd:YAG laser treatment of basal cell carcinoma: A retrospective review. Lasers Surg Med. 2019 Jan;51(1):34-39. https://doi.org/10.1002/lsm.23041
ORTIZ AE, ANDERSON RR, AVRAM MM. 1064 nm long-pulsed Nd:YAG laser treatment of basal cell carcinoma. Lasers Surg Med. 2015 Feb;47(2):106-10. https://doi.org/10.1002/lsm.22310
ORTIZ AE, ANDERSON RR, DIGIORGIO C, JIANG SIB, SHAFIQ F, AVRAM MM. An expanded study of long-pulsed 1064 nm Nd:YAG laser treatment of basal cell carcinoma. Lasers Surg Med. 2018 Feb 13. https://doi.org/10.1002/lsm.22803
KRANZ S, BRUNNMEIER G, YILMAZ P, THAMM J, SCHIELE S, MÜLLER G, KEY C, WELZEL J, SCHUH S. Optical coherence tomography-guided Nd:YAG laser treatment and follow-up of basal cell carcinoma. Lasers Surg Med. 2023 Mar;55(3):257-267. https://doi.org/10.1002/lsm.23638
MOSKALIK K, KOZLOV A, DEMIN E, BOIKO E. The efficacy of facial skin cancer treatment with high-energy pulsed neodymium and Nd:YAG lasers. Photomed Laser Surg. 2009 Apr;27(2):345-9. https://doi.org/10.1089/pho.2008.2327
SULLIVAN T, SMITH J, KERMODE J, MCIVER E, COURTEMANCHE DJ. Rating the burn scar. J Burn Care Rehabil. 1990 May-Jun;11(3):256-60. https://doi.org/10.1097/00004630-199005000-00014
OTA AS, MAGALHAES F, FURTADO GP, GARCIA EB, FERREIRA LM. Validação da versão em português do Patient Scar Assessment Questionnaire. Rev. Bras. Cir. Plást. 2023;38(1):e063. Doi: DOI: 10.5935/2177-1235.2023RBCP0631-PT http://www.dx.doi.org/10.5935/2177-1235.2023RBCP0631-PT
