TY - JOUR
T1 - Laser Treatment for Non-Melanoma Skin Cancer
T2 - A Systematic Review and Meta-Analysis
AU - Sharon, Eran
AU - Snast, Igor
AU - Lapidoth, Moshe
AU - Kaftory, Ran
AU - Mimouni, Daniel
AU - Hodak, Emmilia
AU - Levi, Assi
N1 - Publisher Copyright:
© 2020, Springer Nature Switzerland AG.
PY - 2021/1
Y1 - 2021/1
N2 - Background: Surgery is the mainstay of treatment for non-melanoma skin cancer. Lasers are an additional option. Objective: The objective of this study was to review the literature on the efficacy and safety of lasers for the treatment of non-melanoma skin cancer. Methods: A systematic review and meta-analysis of laser treatment for non-melanoma skin cancer was performed. The primary outcome was recurrence rate (RR). Results: The review included 32 studies (six randomized controlled trials and 26 cohort studies): 27 evaluated basal cell carcinomas (BCCs), three squamous cell carcinomas, and two both, for a total of 4755 BCCs and 214 squamous cell carcinoas. Most BCCs were low risk. The Nd:YAG laser (seven studies, 3286 BCCs) had a 3.1% RR (95% confidence interval [CI] 1.4–6.4%) during a mean follow-up of 7.9 years, with a low rate (< 20%) of scarring and dyspigmentation. The CO2 laser (ten studies, 904 BCCs) had a 9.4% RR (95% CI 4.1–20) during a mean follow-up of 2.1 years, with a low rate of side effects. The pulsed dye laser (eight studies, 206 BCCs) had a 38% RR (95% CI 24–55). In two studies, the Nd:YAG laser demonstrated a RR of 10% (95% CI 2–31) for Bowen’s disease, and in three studies, the CO2 laser demonstrated a RR of 22% (95% CI 5–61) for squamous cell carcinoma. Conclusions: Based on cohort studies, the Nd:YAG laser is a safe and efficacious modality for the treatment of low-risk BCC. Based on settings applied in prior studies in the literature, the CO2 laser is less efficacious than the Nd:YAG laser, thus it cannot be recommended for BCC treatment. Insufficient data preclude conclusions regarding laser treatment for squamous cell carcinoma. Registration: PROSPERO registration number CRD42019129717.
AB - Background: Surgery is the mainstay of treatment for non-melanoma skin cancer. Lasers are an additional option. Objective: The objective of this study was to review the literature on the efficacy and safety of lasers for the treatment of non-melanoma skin cancer. Methods: A systematic review and meta-analysis of laser treatment for non-melanoma skin cancer was performed. The primary outcome was recurrence rate (RR). Results: The review included 32 studies (six randomized controlled trials and 26 cohort studies): 27 evaluated basal cell carcinomas (BCCs), three squamous cell carcinomas, and two both, for a total of 4755 BCCs and 214 squamous cell carcinoas. Most BCCs were low risk. The Nd:YAG laser (seven studies, 3286 BCCs) had a 3.1% RR (95% confidence interval [CI] 1.4–6.4%) during a mean follow-up of 7.9 years, with a low rate (< 20%) of scarring and dyspigmentation. The CO2 laser (ten studies, 904 BCCs) had a 9.4% RR (95% CI 4.1–20) during a mean follow-up of 2.1 years, with a low rate of side effects. The pulsed dye laser (eight studies, 206 BCCs) had a 38% RR (95% CI 24–55). In two studies, the Nd:YAG laser demonstrated a RR of 10% (95% CI 2–31) for Bowen’s disease, and in three studies, the CO2 laser demonstrated a RR of 22% (95% CI 5–61) for squamous cell carcinoma. Conclusions: Based on cohort studies, the Nd:YAG laser is a safe and efficacious modality for the treatment of low-risk BCC. Based on settings applied in prior studies in the literature, the CO2 laser is less efficacious than the Nd:YAG laser, thus it cannot be recommended for BCC treatment. Insufficient data preclude conclusions regarding laser treatment for squamous cell carcinoma. Registration: PROSPERO registration number CRD42019129717.
UR - http://www.scopus.com/inward/record.url?scp=85091072316&partnerID=8YFLogxK
U2 - 10.1007/s40257-020-00562-8
DO - 10.1007/s40257-020-00562-8
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C2 - 32930983
AN - SCOPUS:85091072316
SN - 1175-0561
VL - 22
SP - 25
EP - 38
JO - American Journal of Clinical Dermatology
JF - American Journal of Clinical Dermatology
IS - 1
ER -