Ezughah Francesca I, Affleck Andrew G, Evans Alan, Ibbotson Sally H, Fleming Colin J
Department of Dermatology, Ninewells Hospital and Medical School, Dundee, UK.
J Dermatolog Treat. 2008;19(3):156-8. doi: 10.1080/09546630701759603.
Although the effectiveness of daily dosing regimens of 5% imiquimod cream for the treatment of superficial basal cell carcinomas (sBCC) has been documented by recent studies, concerns about long-term outcome remain. The majority of efficacy data is based on clinical clearance and limited histological examination which may not identify tumour presence at the periphery.
To assess the efficacy of 5% imiquimod cream for sBCC using detailed histological assessment 1 year after completion of treatment.
Nine individuals with biopsy-proven sBCC treated with 5% imiquimod cream 1 year previously and who remained clinically clear were recruited. Paraffin-embedded excision specimens from the original tumour site were extensively examined by a dermatopathologist. Examination and analysis of frozen sections of the original tumour perimeter using Mohs' micrographic surgery (MMS) were then performed.
Eight of nine individuals, 89% (95% CI 56% to 97%) were histologically clear of sBCC at 52 weeks. One individual had a single focus of sBCC at one lateral margin.
The results show agreement between the clinical and histological assessment of tumour clearance. However, the persistence of disease in one patient, although limited, indicates the need for cautious long-term follow-up studies on the use of 5% imiquimod cream for sBCC.
尽管近期研究已证明5%咪喹莫特乳膏每日给药方案治疗浅表性基底细胞癌（sBCC）的有效性，但对长期疗效仍存在担忧。大多数疗效数据基于临床清除情况和有限的组织学检查，而这些检查可能无法识别肿瘤在外周的存在情况。
在治疗完成1年后，通过详细的组织学评估来评估5%咪喹莫特乳膏治疗sBCC的疗效。
招募9名1年前接受5%咪喹莫特乳膏治疗且活检证实为sBCC、临床仍保持清除状态的患者。皮肤科病理学家对来自原肿瘤部位的石蜡包埋切除标本进行了广泛检查。然后使用莫氏显微外科手术（MMS）对原肿瘤边缘的冰冻切片进行检查和分析。
9名患者中有8名（89%，95%可信区间56%至97%）在52周时组织学上清除了sBCC。1名患者在一侧边缘有单个sBCC病灶。
结果显示肿瘤清除的临床评估和组织学评估之间具有一致性。然而，1名患者疾病持续存在，尽管范围有限，这表明有必要对5%咪喹莫特乳膏治疗sBCC进行谨慎的长期随访研究。
