{"entity":{"id":"mal-pdt-versus-cryotherapy-superficial-bcc","kind":"trial","name":"Photodynamic therapy against cryotherapy for superficial basal cell carcinoma","aka":["Basset-Seguin trial","MAL-PDT versus cryotherapy in superficial basal cell carcinoma"],"tldr":"Freezing a thin basal cell carcinoma with liquid nitrogen and treating it with light gave the same number of recurrences five years later. What separated them was how the skin looked afterwards, and light was much better.","summary":"Cryotherapy is the oldest and cheapest of the destructive treatments and the one most often done in a general practice or a minor operations clinic. This multicentre randomised trial compared it against methyl aminolevulinate photodynamic therapy in primary superficial basal cell carcinoma: 60 patients with 114 lesions were given one session of photodynamic therapy and 58 patients with 105 lesions had cryotherapy with two freeze-thaw cycles, with re-treatment of incomplete responders at three months.\n\nOne hundred lesions treated with photodynamic therapy and 93 treated with cryotherapy were in complete response at three months after the last treatment and could be followed for recurrence. Over five years there was no difference in recurrence: 20 per cent after cryotherapy against 22 per cent after photodynamic therapy, p=0.86.\n\nThe difference was in the skin. An excellent cosmetic outcome was recorded in 60 per cent of the photodynamic therapy group against 16 per cent of the cryotherapy group, p=0.00078. Cryotherapy leaves a pale, often depressed scar with a permanent loss of pigment, which on a face is exactly what a person notices. Both results, the equality of recurrence and the inequality of appearance, matter: this is a trial in which the cheap old treatment holds its own on the outcome the doctor measures and loses on the outcome the patient sees.","status":"mixed","asOf":"2026-09-25","links":[{"label":"Five-year randomised comparison (European Journal of Dermatology 2008)","url":"https://doi.org/10.1684/ejd.2008.0472"},{"label":"Five-year randomised comparison on PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/18693158/"}],"tags":[],"related":[],"cancers":["basal-cell-carcinoma","skin-cancer"],"sections":[],"technologies":["photodynamic-therapy-lasers","cryoablation"],"targets":[],"drugs":["aminolevulinic-acid"],"companies":[],"institutions":[],"pathways":[],"terms":["topical-and-destructive-treatment-bcc"],"trials":["mal-pdt-versus-surgery-nodular-bcc","mal-pdt-imiquimod-fluorouracil-superficial-bcc"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"phase":"3","setting":"Primary superficial basal cell carcinoma: methyl aminolevulinate photodynamic therapy in one session against cryotherapy with two freeze-thaw cycles, with re-treatment of incomplete responders and lesion recurrence over five years","sponsor":"Photocure and Galderma, run in European dermatology centres","result":"Five-year recurrence 20 per cent after cryotherapy against 22 per cent after methyl aminolevulinate photodynamic therapy (p=0.86), with an excellent cosmetic outcome in 16 against 60 per cent (p=0.00078).","yearReported":2008,"enrolled":118,"enrolledBasis":"randomised","enrolledNote":"60 patients with 114 lesions were randomised to photodynamic therapy and 58 with 105 lesions to cryotherapy, 118 patients in all; the trial ran before trial registration was required and has no registry record.","outcomes":[{"endpoint":"Lesion recurrence at 5 years","primary":true,"unit":"%","arms":[{"name":"Cryotherapy, two freeze-thaw cycles","n":93,"value":20},{"name":"Methyl aminolevulinate photodynamic therapy","n":100,"value":22}],"p":"0.86","source":"https://doi.org/10.1684/ejd.2008.0472"},{"endpoint":"Excellent cosmetic outcome","unit":"%","arms":[{"name":"Cryotherapy, two freeze-thaw cycles","value":16},{"name":"Methyl aminolevulinate photodynamic therapy","value":60}],"p":"0.00078","source":"https://doi.org/10.1684/ejd.2008.0472"}],"replication":"The Dutch three-arm trial did not include cryotherapy, so there is no head-to-head evidence placing cryotherapy against imiquimod or fluorouracil; the comparison people make in clinic rests on this trial and on the separate photodynamic therapy comparisons."},"route":"/trials/mal-pdt-versus-cryotherapy-superficial-bcc/","neighbours":{"cancer":[{"id":"basal-cell-carcinoma","kind":"cancer","name":"Basal cell carcinoma","route":"/cancers/basal-cell-carcinoma/"},{"id":"skin-cancer","kind":"cancer","name":"Skin cancer (all types)","route":"/cancers/skin-cancer/"}],"technology":[{"id":"photodynamic-therapy-lasers","kind":"technology","name":"Photodynamic therapy lasers and light sources","route":"/technologies/photodynamic-therapy-lasers/"}],"term":[{"id":"topical-and-destructive-treatment-bcc","kind":"term","name":"Creams, light and cold for basal cell carcinoma","route":"/terms/topical-and-destructive-treatment-bcc/"},{"id":"cryoablation","kind":"term","name":"Cryoablation","route":"/terms/cryoablation/"}],"drug":[{"id":"aminolevulinic-acid","kind":"drug","name":"Aminolevulinic acid (topical, for photodynamic therapy)","route":"/drugs/aminolevulinic-acid/"}],"trial":[{"id":"mal-pdt-imiquimod-fluorouracil-superficial-bcc","kind":"trial","name":"Photodynamic therapy against imiquimod against fluorouracil for superficial basal cell carcinoma","route":"/trials/mal-pdt-imiquimod-fluorouracil-superficial-bcc/"},{"id":"mal-pdt-versus-surgery-nodular-bcc","kind":"trial","name":"Photodynamic therapy against surgery for nodular basal cell carcinoma","route":"/trials/mal-pdt-versus-surgery-nodular-bcc/"}]}}