Original Title: Terapia fotodinâmica para lesões de pele não melanoma

Authors' objectives: Is photodynamic therapy effective, safe and cost-effective for the treatment of non-melanoma skin cancer when compared to surgery?

Authors' results and conclusions: The CONITEC’s members present at the 85th Ordinary Meeting, on February 4th, 2020, unanimously decided not to recommend the incorporation of photodynamic therapy for the treatment of non-melanoma skin cancer lesions, specifically superficial basal cell carcinoma, as an alternative to surgery. The Deliberation Record No. 498/2020 was signed.

Authors' recommendations: Scientific evidence: Photodynamic therapy (PDT) was shown to be less effective than surgery for the complete resolution of the lesion (risk ratio [RR] = 0.93; 95% confidence interval [CI] 0.89-0.98). The studies analyzed were heterogeneous regarding the risk of recurrence at 12 months, affecting the accuracy of the results and impacting on the quality of the evidence, but the results showed that patients treated with photodynamic therapy presented 12 times more chance of lesion recurrence compared with the group treated with surgery (RR 12.42; CI 2.34-66.02). A better cosmetic effect was twice as high with photodynamic therapy (odds ratio [OR] 1.87; CI 1.54-2.26) compared with the group treated with surgery. Budget impact analysis: Based on the budget impact scenarios developed, it would be necessary to increase the budget by more than BRL 3 million in one year, in order to make PDT available to all patients with superficial basal cell carcinomas. In an alternative scenario, where PDT would be restricted to superficial head and neck tumors, the incremental impact was estimated to be approximately BRL 1.1 million. Considerations: The findings have demonstrated that photodynamic therapy is effective in removing lesions, with cosmetic advantages when compared with traditional surgery, but also with a higher risk of recurrence. Photodynamic therapy can be an alternative to surgical excision for low-risk superficial tumors in situations where the cosmetic outcome has a significant impact on the choice of treatments.

Project Status: Completed

URL for project: http://conitec.gov.br/images/Consultas/Relatorios/EN2020/20200915_Report507_PhotodynamicTherapy_non-melanoma_skincancer.pdf

Year Published: 2020

URL for published report: http://conitec.gov.br/images/Relatorios/2020/Relatorio_Fototerapia_lesoes_pele_nao_melanoma-_507_2020_FINAL.pdf

URL for additional information: http://conitec.gov.br/recomendation-reports

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Brazil

Organisation Name: National Committee for Technology Incorporation (CONITEC)

Contact Address: Esplanada dos Ministérios, Bl. G, Ed. Sede, 8º andar, CEP: 70058-900

Contact Name: Clarice Moreira Portugal

Contact Email: clarice.portugal@saude.gov.br

Copyright: 2021 Conitec