Laser Treatment for Non-Melanoma Skin Cancer: A Systematic Review and Meta-Analysis

Eran Sharon, Igor Snast*, Moshe Lapidoth, Ran Kaftory, Daniel Mimouni, Emmilia Hodak, Assi Levi

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)25-38
Number of pages14
JournalAmerican Journal of Clinical Dermatology
Volume22
Issue number1
DOIs
StatePublished - Jan 2021

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