Ultrasound monitoring of the effectiveness of photodynamic therapy for basal cell skin cancer of the head and neck

To develop a standardized methodology and a step-by-step algorithm for ultrasound monitoring in order to objectively and dynamically evaluate the effectiveness of photodynamic therapy in patients with basal cell carcinoma of the head and neck. Materials and methods. Primary ultrasound examination was conducted in 130 patients diagnosed with basal cell carcinoma of the head and neck, who were subsequently referred for photodynamic therapy. Of these, 68.5 % were female and 31.5 % male, with ages ranging from 40 to 93 years. Dynamic ultrasound monitoring was performed at early (24–72 hours) and long-term intervals (3, 6, and 12 months) following treatment. Results. The optimal time intervals for ultrasound monitoring of skin changes during the treatment of basal cell carcinoma in the head and neck have been determined, considering the various stages of therapy. The initial ultrasound examination is conducted prior to photodynamic therapy to characterize the tumor and accurately select the parameters for laser exposure. After therapy, ultrasound scans are performed at 24, 48, and 72 hours to monitor the post-treatment effect and detect any pathomorphological changes resulting from the treatment. In 2.3 % of cases, residual vascularization persisted, necessitating a repeat session of photodynamic therapy. Long-term monitoring continues at the stages of scar formation and tissue regeneration, with examinations conducted at 3, 6, and 12 months after treatment. This schedule allows for a comprehensive evaluation of recovery dynamics and facilitates early detection of potential relapse. In 5.4 % of cases involving the margin of normotrophic scar, signs of continued growth were identified. Conclusion. A scientifically validated, reproducible, and clinically feasible method has been developed, featuring a detailed stepwise ultrasound monitoring protocol that enables an accurate and objective evaluation of photodynamic therapy effectiveness for basal cell carcinoma of the head and neck. This approach significantly enhances diagnostic precision, allows for meticulous tracking of treatment progression, and facilitates timely, evidence-based decisions regarding therapy optimization and subsequent patient management.