A feasibility study of microwave therapy for precancerous actinic keratoses

D. N. Jackson, F. J. Hogarth, D. Sutherland, E. M. Holmes, P. T. Donnan, C. M. Proby (Lead / Corresponding author)

Research output: Contribution to journalArticle

Abstract

Background: Actinic keratosis (AK) is a common pre-malignant skin lesion that can progress to cutaneous squamous cell carcinoma (cSCC). Microwave therapy is an established cancer treatment and has been used for plantar viral warts.

Objectives: To evaluate the efficacy and feasibility of microwave as a treatment for AK.

Methods: Stage 1 was a dose-setting study, where seven participants had the dielectric properties of 12 thick and 22 thin AK assessed for optimisation of the microwave dose used for treatment in Stage 2. Stage 2 was a randomised, internally-controlled trial evaluating 179 AK in 11 patients (93 treated, 86 untreated controls) on the scalp/forehead or dorsal hand. Participants received one treatment initially and a repeat treatment to unresolved AK at week 4. Response was assessed at 6 visits over 4 months. The primary outcome was partial or complete resolution of the treated AK.

Results: A significantly higher proportion of treated AK areas responded than untreated ( 90% vs 13%; p-value < 0.001). Thin AK were more responsive than thick AK. Site did not affect efficacy. Pain was severe, but brief (80% reported pain lasting "a few seconds only"). Adverse effects were minimal (redness n=6, flaking n=3, itching n=3). All participants who would choose microwave therapy over their current treatment cited the shorter discomfort period.

Conclusions: Microwave therapy is a portable, safe and effective treatment for AK. An easy to deliver, acceptable therapy for AK is attractive as a prevention strategy. Whilst these results are promising, a larger randomised controlled trial is needed against an effective comparator to confirm clinical efficacy and patient acceptability.

Original languageEnglish
JournalBritish Journal of Dermatology
DOIs
Publication statusE-pub ahead of print - 6 Feb 2020

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Actinic Keratosis
Feasibility Studies
Microwaves
Therapeutics
Randomized Controlled Trials
Pain
Skin
Warts
Forehead
Pruritus
Scalp
Squamous Cell Carcinoma
Hand

Cite this

@article{4ff3fcf8b66b4aefa9b1bff23ef600b1,
title = "A feasibility study of microwave therapy for precancerous actinic keratoses",
abstract = "Background: Actinic keratosis (AK) is a common pre-malignant skin lesion that can progress to cutaneous squamous cell carcinoma (cSCC). Microwave therapy is an established cancer treatment and has been used for plantar viral warts.Objectives: To evaluate the efficacy and feasibility of microwave as a treatment for AK.Methods: Stage 1 was a dose-setting study, where seven participants had the dielectric properties of 12 thick and 22 thin AK assessed for optimisation of the microwave dose used for treatment in Stage 2. Stage 2 was a randomised, internally-controlled trial evaluating 179 AK in 11 patients (93 treated, 86 untreated controls) on the scalp/forehead or dorsal hand. Participants received one treatment initially and a repeat treatment to unresolved AK at week 4. Response was assessed at 6 visits over 4 months. The primary outcome was partial or complete resolution of the treated AK.Results: A significantly higher proportion of treated AK areas responded than untreated ( 90{\%} vs 13{\%}; p-value < 0.001). Thin AK were more responsive than thick AK. Site did not affect efficacy. Pain was severe, but brief (80{\%} reported pain lasting {"}a few seconds only{"}). Adverse effects were minimal (redness n=6, flaking n=3, itching n=3). All participants who would choose microwave therapy over their current treatment cited the shorter discomfort period.Conclusions: Microwave therapy is a portable, safe and effective treatment for AK. An easy to deliver, acceptable therapy for AK is attractive as a prevention strategy. Whilst these results are promising, a larger randomised controlled trial is needed against an effective comparator to confirm clinical efficacy and patient acceptability.",
author = "Jackson, {D. N.} and Hogarth, {F. J.} and D. Sutherland and Holmes, {E. M.} and Donnan, {P. T.} and Proby, {C. M.}",
note = "grant funded by Innovate UK under Competition “Health & Life Sciences Round 1”, Project reference 103352, “MTAK - Microwave Therapy for Actinic Keratosis”. Emblation Ltd supplied the Swift{\circledR} Microwave device and single use probes for the duration of the trial.This article is protected by copyright. All rights reserved.",
year = "2020",
month = "2",
day = "6",
doi = "10.1111/bjd.18935",
language = "English",
journal = "British Journal of Dermatology",
issn = "0007-0963",
publisher = "Wiley",

}

A feasibility study of microwave therapy for precancerous actinic keratoses. / Jackson, D. N.; Hogarth, F. J.; Sutherland, D.; Holmes, E. M.; Donnan, P. T.; Proby, C. M. (Lead / Corresponding author).

In: British Journal of Dermatology, 06.02.2020.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A feasibility study of microwave therapy for precancerous actinic keratoses

AU - Jackson, D. N.

AU - Hogarth, F. J.

AU - Sutherland, D.

AU - Holmes, E. M.

AU - Donnan, P. T.

AU - Proby, C. M.

N1 - grant funded by Innovate UK under Competition “Health & Life Sciences Round 1”, Project reference 103352, “MTAK - Microwave Therapy for Actinic Keratosis”. Emblation Ltd supplied the Swift® Microwave device and single use probes for the duration of the trial.This article is protected by copyright. All rights reserved.

PY - 2020/2/6

Y1 - 2020/2/6

N2 - Background: Actinic keratosis (AK) is a common pre-malignant skin lesion that can progress to cutaneous squamous cell carcinoma (cSCC). Microwave therapy is an established cancer treatment and has been used for plantar viral warts.Objectives: To evaluate the efficacy and feasibility of microwave as a treatment for AK.Methods: Stage 1 was a dose-setting study, where seven participants had the dielectric properties of 12 thick and 22 thin AK assessed for optimisation of the microwave dose used for treatment in Stage 2. Stage 2 was a randomised, internally-controlled trial evaluating 179 AK in 11 patients (93 treated, 86 untreated controls) on the scalp/forehead or dorsal hand. Participants received one treatment initially and a repeat treatment to unresolved AK at week 4. Response was assessed at 6 visits over 4 months. The primary outcome was partial or complete resolution of the treated AK.Results: A significantly higher proportion of treated AK areas responded than untreated ( 90% vs 13%; p-value < 0.001). Thin AK were more responsive than thick AK. Site did not affect efficacy. Pain was severe, but brief (80% reported pain lasting "a few seconds only"). Adverse effects were minimal (redness n=6, flaking n=3, itching n=3). All participants who would choose microwave therapy over their current treatment cited the shorter discomfort period.Conclusions: Microwave therapy is a portable, safe and effective treatment for AK. An easy to deliver, acceptable therapy for AK is attractive as a prevention strategy. Whilst these results are promising, a larger randomised controlled trial is needed against an effective comparator to confirm clinical efficacy and patient acceptability.

AB - Background: Actinic keratosis (AK) is a common pre-malignant skin lesion that can progress to cutaneous squamous cell carcinoma (cSCC). Microwave therapy is an established cancer treatment and has been used for plantar viral warts.Objectives: To evaluate the efficacy and feasibility of microwave as a treatment for AK.Methods: Stage 1 was a dose-setting study, where seven participants had the dielectric properties of 12 thick and 22 thin AK assessed for optimisation of the microwave dose used for treatment in Stage 2. Stage 2 was a randomised, internally-controlled trial evaluating 179 AK in 11 patients (93 treated, 86 untreated controls) on the scalp/forehead or dorsal hand. Participants received one treatment initially and a repeat treatment to unresolved AK at week 4. Response was assessed at 6 visits over 4 months. The primary outcome was partial or complete resolution of the treated AK.Results: A significantly higher proportion of treated AK areas responded than untreated ( 90% vs 13%; p-value < 0.001). Thin AK were more responsive than thick AK. Site did not affect efficacy. Pain was severe, but brief (80% reported pain lasting "a few seconds only"). Adverse effects were minimal (redness n=6, flaking n=3, itching n=3). All participants who would choose microwave therapy over their current treatment cited the shorter discomfort period.Conclusions: Microwave therapy is a portable, safe and effective treatment for AK. An easy to deliver, acceptable therapy for AK is attractive as a prevention strategy. Whilst these results are promising, a larger randomised controlled trial is needed against an effective comparator to confirm clinical efficacy and patient acceptability.

U2 - 10.1111/bjd.18935

DO - 10.1111/bjd.18935

M3 - Article

C2 - 32030723

JO - British Journal of Dermatology

JF - British Journal of Dermatology

SN - 0007-0963

ER -