THE EXPERIENCE OF TREATMENT OF MULTIPLE BASALIOMA IN GORLIN-GOLTZ SYNDROME

Aim: To assess clinical efficacy of the treatment options for multiple basalioma in patients with Gorlin-Goltz syndrome. Materials and methods: We retrospectively analyzed the results of various treatments in 23  patients with the Gorlin-Goltz syndrome for the time period of 25  years. Four treatment groups were formed depending on the treatment method. In the group 1, 18 patients were cryodestructed, with elimination of 158  superficial and ulcer basaliomas T₁N₀M₀, T₂N₀M₀, T₃N₀M₀. In the group 2, 5  patients received photodynamic therapy, with removal of 78 superficial, nodular and ulcer basaliomas T₁N₀M₀, T₂N₀M₀, T₃N₀M₀. In the group 3, 3  patients were administered laser-induced thermic therapy with removal of 16  superficial basaliomas T₁N₀M₀. In the group 4, 5 patients received topical chemotherapy with Mardil Selen, with removal of 18  superficial and ulcer basaliomas T₁N₀M₀. As radiation sources for photodynamic and laser-induced thermic therapy we used laser equipment with copper vaporization and adjusted wave length Metalaz 1  and semiconductor infrared laser LAMI. The photodynamic therapy was administered with photosensitizers Photohem and Radachlorin. The results of treatment and relapse-free periods were assessed annually in all patients up to 5  years after treatment. Results: After cryodestruction, 83.3%  of patients with Gorlin-Goltz syndrome were cured (153  basaliomas) and additional 16.7%  improved. Relapses during the time period from one to three years were observed in 16.7% of patients. Nine (9) basaliomas relapsed. After photodynamic therapy, 80%  of patients (73  basaliomas) were cured and 20%  improved. Relapses from 1  to 3  years were observed in 20% of patients (2 basaliomas). After laser-induced thermic therapy 100%  of patients (16  basaliomas were cured), and relapses from 1  to 2  years were registered in 33%  of patients (4 basaliomas). After topical treatment with Mardil Selen 80% of patients (12 basaliomas) were cured and 20% of patients improved. Relapses from 1 to 3  years were seen in 20%  of patients (3  basaliomas). Conclusion: Taking into account the disease specifics and a wide range of treatments and non-invasive therapies, none of the suggested treatment approaches for multiples basalioma associated with the Gorlin-Goltz syndrome can reliably prevent the relapses. In addition to radical treatment, preventive administration of aromatic steroids is necessary.