A retrospective study comparing different injection approaches of 5-aminolevulinic acid in patients with non-melanoma skin cancer

Abstract

Background

5-aminolevulinic acid through a needle-free, plum-blossom needle or conventional needle followed by photodynamic therapy are available options for non-melanoma skin cancer treatment.

Aim

To compare these three techniques of injection of 5-aminolevulinic, regarding treatment response and adverse effects in patients with non-melanoma skin cancer.

Patients and methods

Non-melanoma skin cancer patients have received six cycles of 0.5 mL intralesional 20% w/v 5-aminolevulinic acid through a conventional needle (CPT cohort, n = 158), or plum-blossom needle (BPT cohort, n = 118), or needle-free injection (NPT cohort, n = 105) followed by irradiation with a red light. Data regarding treatment response and adverse effects were collected and analyzed.

Results

The treatment response was higher among patients of NPT cohort than those of CPT (p = .012, q = 3.981) and BPT (p = .012, q = 3.472) cohorts. Conventional and plum-blossom needle injections therapies were reported scar, local redness, and worse cosmetic appearance in the follow-up period.

Conclusions

Needle-free injection of intralesional 5-aminolevulinic acid followed by irradiation with red light therapy were reported high treatment response with manageable adverse effects for non-melanoma skin cancer patients than that of conventional and plum-blossom needle injections.

Level of evidence

III.

Keywords:

• 5-Aminolevulinic acid
• Chinese dermal needle
• needle-free injection
• non-melanoma skin cancer
• photodynamic therapy

Acknowledgments

The authors are thankful for the medical staff of the Tianjin Baodi Hospital, Baodi Clinical College of Tianjin Medical University, Tianjin, China and Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases; Artificial Cell Engineering Technology Research Center; Tianjin Institute of Hepatobiliary Disease, Tianjin, China.

Author contributions

The authors read and approved the manuscript for publication. WZ and JW equally contributed to supervision, resources, the literature review, formal analysis, and data curation of the study. YZ was project administrator and contributed to methodology, supervision, resources, and the literature review of the study. BZ contributed to investigation, resources, literature review, and software of the study, draft and edited the manuscript for intellectual content. The authors agree to be accountable for all aspects of work ensuring integrity and accuracy.

Disclosure statement

The authors declared that they have no conflict of interest or any other competing interest regarding results and/or discussion reported in the research.

Data availability statement

The datasets used and analyzed during the current study available from the corresponding author on reasonable request.