Meta-analysis reports high pooled complete response with ALA/MAL photodynamic therapy for superficial BCC

This publication is a systematic review and meta-analysis of photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) or methyl aminolevulinate (MAL) for histologically confirmed superficial (sBCC) and nodular (nBCC) basal cell carcinoma. The review adhered to PRISMA 2020 guidelines, with searches of PubMed, Embase, Cochrane Library, and Web of Science through December 31, 2025. Eligible studies included randomized controlled trials and single-arm studies; non-randomized study quality was assessed with the MINORS scale, and analyses were performed in Review Manager 5.4.

Of 3832 records identified, 55 studies were included (41 evaluating sBCC and 34 evaluating nBCC), encompassing 2123 patients and 2995 lesions. For sBCC, the pooled complete response rate was 0.88 (95% CI: 0.85–0.91). Results for nBCC, long-term recurrence, cosmetic outcomes, adverse events, and comparator interventions are not shown in the available abstract text, which is truncated.

Clinicians should interpret these findings as supporting a high pooled complete response rate for ALA/MAL-PDT in superficial BCC, consistent with its role as a non-invasive alternative to surgical excision when cosmetic or functional considerations favor lesion-sparing therapy. Because the visible abstract does not report nBCC-specific efficacy, safety outcomes, follow-up duration, or heterogeneity metrics, comparative positioning against surgery for nodular disease cannot be assessed from this excerpt. Durability of response and patient selection criteria warrant review of the full text before practice changes.