Ceilley Roger I, Del Rosso James Q
Department of Dermatology, University of Iowa School of Medicine, Iowa City, IA, USA.
Int J Dermatol. 2006 May;45(5):489-98. doi: 10.1111/j.1365-4632.2006.02673.x.
Basal cell carcinoma (BCC) is one of the most common cancers. Surgical extirpation is currently the standard of care for BCC, which is associated with several advantages and disadvantages. Procedures such as surgical excision used to treat superficial BCC (sBCC) and nodular BCC (nBCC) may have high 5-year recurrence rates if tumors are not completely excised. Curettage with electrodesiccation is a common method for treating primary BCC. However, multiple cycles are recommended and the procedure can have unsatisfactory cosmetic results (e.g. scarring and hypopigmentation). Mohs micrographic surgery has a low rate of disease recurrence but is a specialized procedure usually limited to specific indications (e.g. high-risk tumors). Cryosurgery and photodynamic therapy require multiple cycles and are associated with variable cosmetic outcomes and recurrence rates. As with any procedure, potential risks and patient quality-of-life issues need to be considered. In addition, substantial patient and healthcare provider inconvenience limit the practical utility of some modalities. Pharmacologic interventions provide another treatment option as adjunctive or monotherapy. Investigations of imiquimod, a novel immune response modifier, have indicated that this topical, noninvasive agent is safe and well tolerated and may be efficacious in the treatment of BCC. This review will highlight the role of standard treatment modalities and introduce new advances in the treatment of BCC.
基底细胞癌（BCC）是最常见的癌症之一。手术切除是目前BCC的标准治疗方法，它有一些优点和缺点。用于治疗浅表性BCC（sBCC）和结节性BCC（nBCC）的手术切除等操作，如果肿瘤未完全切除，5年复发率可能较高。刮除术加电干燥法是治疗原发性BCC的常用方法。然而，建议进行多个疗程，且该操作可能会有不理想的美容效果（如瘢痕形成和色素减退）。莫氏显微外科手术疾病复发率低，但它是一种特殊的手术，通常限于特定适应证（如高危肿瘤）。冷冻手术和光动力疗法需要多个疗程，且与不同的美容效果和复发率相关。与任何手术一样，需要考虑潜在风险和患者生活质量问题。此外，给患者和医疗服务提供者带来的极大不便限制了某些治疗方式的实际应用。药物干预作为辅助治疗或单一疗法提供了另一种治疗选择。对新型免疫反应调节剂咪喹莫特的研究表明，这种局部、非侵入性药物安全且耐受性良好，可能对BCC治疗有效。本综述将重点介绍标准治疗方式的作用，并介绍BCC治疗的新进展。
