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Neoadjuvant Photodynamic Therapy: An Updated Therapeutic Approach for Non-Melanoma Skin Cancers

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Opinion Statement

Non-melanoma skin cancers (NMSCs) are the most common malignancy and surgical excision is considered treatment of choice for the majority of cases. However, surgery can be very extensive in cases of large, multiple, or cosmetic-sensitive tumors located on areas such as scalp and face or genital region, leading to significant functional and cosmetic deficit. Aminolaevulinic acid photodynamic therapy (ALA-PDT) has emerged as a widely used approach in a variety of skin diseases, demonstrating remarkable efficacy in treatment of actinic keratosis, Bowen disease and basal cell carcinoma. Besides, when employed as a preoperative intervention, ALA-PDT effectively reduces tumor size and minimizes subsequent local surgical morbidity. With its minimally invasive nature and proven effectiveness, ALA-PDT holds significant promise as a neoadjuvant treatment option for NMSCs. In cases where the tumor is large, invasive, multiple, or located in cosmetically and functionally sensitive areas, or when considering patient factors such as age, comorbidity, willingness to undergo surgery, and post-operative quality-of-life, surgical intervention or radiotherapy alone may be impracticable or unacceptable. In such scenarios, neoadjuvant ALA-PDT can offer remarkable outcomes. In order to further ensure the maximum benefit of patients from neoadjuvant PDT, collaboration with multidisciplinary teams and whole-process management may be in need.

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No datasets were generated or analysed during the current study.

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Funding

This work was supported by the National key research and development program of China (2022YFC2504700 and 2022YFC2504705) and the National Natural Science Foundation of China (82073013, 81872212).

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Author notes

  1. Jia Yan and Bo Wang contributed equally to this work.

Authors and Affiliations

  1. Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China

    Jia Yan MD, Guolong Zhang MD, PhD, Caihe Liao MD, Zijun Zhao MD, Peiru Wang MD, PhD & Xiuli Wang MD, PhD

  2. Avera Medical Group Aberdeen, South Dakota, Aberdeen, 57401, USA

    Bo Wang MD, PhD

  3. Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA

    Bo Wang MD, PhD

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  1. Jia Yan MD
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JY, BW contributed equally to the writing of the manuscript and should be considered as co-first authors. GZ and CL revised manuscript and ZZ modified the figure. XW and PW provided guidance and foundation for the project. All authors have read and approved the final manuscript.

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Correspondence to Peiru Wang MD, PhD or Xiuli Wang MD, PhD.

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Yan, J., Wang, B., Zhang, G. et al. Neoadjuvant Photodynamic Therapy: An Updated Therapeutic Approach for Non-Melanoma Skin Cancers. Curr. Treat. Options in Oncol. (2024). https://doi.org/10.1007/s11864-024-01209-0

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