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Stacked laser pulses cleared nonmelanoma skin cancer in one treatment

A pulsed-laser in a stacked pulse setting destroyed nonmelanoma skin cancer in a single treatment, according to recent study results.

Researchers evaluated 20 patients (10 men; median age 62 years) with 23 skin cancers (20 basal cell carcinomas and three squamous cell carcinoma in situ) measuring 0.4 cm to 3 cm and mainly located on patients’ upper extremities and trunk.

S. Brian Jiang

The patients were divided into three cohorts, including a control group that did not receive treatment. Group one (S1) was treated with a 595 nm pulsed-dye laser at 15 J/cm² for 3 milliseconds, with no dynamic cooling on a 7-mm spot size with 10% pulse overlap and two single nonstacked pulses. Group two (S2) underwent the same technique at 7.5 J/cm² for 3 milliseconds, no dynamic cooling, but treatment included an enlarged spot size of 10 mm and double-stacked pulses. Lesions were excised and examined by histopathology.

There was no significant difference between tumor dimensions in the study groups. Among controls, two of seven lesions had no residual tumors (background tumor clearance rate approximately 28%). The S1 group had two of eight lesions with no residual lesions (clearance rate 25%), and S2 had five of seven lesions cleared (71%). The two other lesions in the S2 group were beyond the central treatment zone and would have resulted in 100% clearance if excluded.

Researchers said the results are “most likely due to the stacking of pulses, which creates greater thermal damage than the single passes used in prior studies. Given the small size of this pilot study, further larger-scale studies will be needed to determine statistical significance and long-term recurrence rates.”

“This is a promising alternative to treat [basal cell carcinomas] on the trunk and extremities for those patients unwilling or unable to undergo conventional excisional surgery,” researcher S. Brian Jiang, MD, associate clinical professor of dermatology at the University of California, San Diego, told Healio.com.