Combination treatment with pulsed dye and Nd:YAG lasers is effective for some basal cell carcinoma (BCC) and may offer better cosmetic outcomes for patients, according to a new study published in Lasers in Surgery and Medicine (January 2014).
For “Combined 585nm Pulsed-Dye and 1,064nm Nd:YAG Lasers for the Treatment of Basal Cell Carcinoma”), Harvard researchers, H. Ray Jalian, MD, et al, studied the outcomes of 10 patients with 13 biopsy-proven BCCs who underwent four combined PDL and Nd:YAG at treatments two to four week intervals.
None of the BCCs met the criteria for Mohs micrographic surgery. The tumor and 4mm of peripheral skin were treated using standardized parameters delivered with a 7mm spot with 10% overlap. The treated area was excised and evaluated histologically for residual tumor. The primary study endpoint was histologic clearance of tumor. The secondary study endpoint was a blinded investigator assessment of clinical endpoint and adverse effects.
“The findings in this research study underscore the potential utility of using vascular lasers to target skin cancer. All cancers, whether they are in the skin or elsewhere, rely on a rich blood supply to support rapid growth of the tumor. Oftentimes these blood vessels are abnormal and different from the surrounding blood vessels in the tissue. If we are able to selectively target them, then we may be able to inhibit growth of tumors. In this study, we combined two different wavelengths of light that target blood. We found that many skin cancers less than 1.5cm cleared with a series of four treatments. This study also uncovered some potential reasons for treatment failure including tumors that were of a certain subclass (superficial basal cell carcinoma) and the use of blood thinners, which may inhibit clot formation after laser treatment,” said Dr. Jalian.
The use of vascular-specific lasers that specifically target and destroy abnormal blood vessels allows for selective destruction of the BCC cells with “minimal damage to the surrounding tissue,” said Zeina Tannous, MD, one of the authors of the study. “We have previously demonstrated the efficacy of other vascular specific lasers such as pulsed dye and alexandrite lasers in the treatment of BCC. In this study, we again confirm the efficacy of a combined pulsed dye and Nd:YAG vascular specific laser for BCC treatment.”