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Nebenwirkungen der topischen photodynamischen Therapie

Side effects of topical photodynamic therapy

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Zusammenfassung

Die photodynamische Therapie (PDT) gewinnt im klinischen Alltag bei der Behandlung von Hautkrebs und seinen Vorläufern zunehmend an Bedeutung. Die Studien zu dieser Methodik konzentrieren sich v. a. auf die Demonstration der Effektivität dieser Methode. Damit eine Methode sich durchsetzt, wird im Sinne der Nutzenbewertung die Analyse der Nebenwirkungen unter Alltagsbedingungen gefordert. In der vorliegenden Studie wurden von 2001–2006 im klinischen Alltag 2013 Patienten mittels PDT behandelt. Mithilfe eines speziell konzipierten Protokolls wurden insbesondere die Nebenwirkungen im Verlauf erfasst und analysiert. Die häufigste Nebenwirkung (92%) waren Schmerzen während und nach der Bestrahlung, gefolgt von Erythem/Ödem (89%) und Schuppung mit Juckreiz (80%). Seltener traten Verkrustungen (9%), Pustulationen (6%), großflächige Erosionen (1,2%), Hypo- und Hyperpigmentierungen (1%) und Infektionen (0,3%) auf. Insbesondere großflächige Pustulationen und Erosionen verunsicherten die Patienten sehr stark. Eine ausführliche detaillierte Aufklärung bezüglich der Nebenwirkungen sollte vor jeder PDT erfolgen, zumal bei geeigneter Betreuung die Nebenwirkungen in der Regel sehr gut beherrschbar sind, folgenlos abheilen und das Behandlungsergebnis nicht beeinträchtigen.

Abstract

Photodynamic therapy (PDT) is gaining increasing significance in the treatment of skin cancers and precancerous lesions. Most of the studies dealing with this procedure focus on efficacy. Whereas treatment results are a decisive parameter, before any therapy is accepted the evaluation should also consider side effects in daily practice. We treated 2031 patients with PDT between 2001 and 2006, and evaluated the side effects during and after treatment with a specially designed protocol. The most prominent side effect was pain, which occurred in 92% of patients, followed by erythema/edema (89%) and scaling in conjunction with itching (80%). Less common unwanted effects included crusting (9%), pustules (6%), large erosions (1.2%), pigmentary changes (1%) and infections (0.4%). Especially widespread erosions and pustules caused significant anxiety for the patients. Patients should be informed in detail about the side effects of PDT prior to treatment, since most of the unwanted effects are easily managed, heal without scarring and do not influence the therapeutic response.

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  1. Zentrum für Dermatologie, Allergologie und Umweltmedizin, HELIOS Klinikum Wuppertal,Universitätsklinikum der Universität Witten-Herdecke, Heusnerstraße 40, 42283, Wuppertal, Deutschland

    P. Lehmann

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Lehmann, P. Nebenwirkungen der topischen photodynamischen Therapie. Hautarzt 58, 597–603 (2007). https://doi.org/10.1007/s00105-007-1363-4

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