Helsing Per, Gjersvik Petter, Tarstedt Mikael
Department of Dermatology, Oslo University Hospital, Oslo, Norway.
Institute for Clinical Medicine, University of Oslo, Oslo, Norway.
Int J Dermatol. 2015 Sep;54(9):1030-3. doi: 10.1111/ijd.12599. Epub 2015 Feb 6.
Basal cell carcinoma (BCC) is a locally destructive form of skin cancer, mainly affecting Caucasians. There are multiple treatment options for BCC, with excisional surgery being most widely used. Choice of treatment may be dependent on clinical guidelines, local therapeutic traditions, and/or personal experience. Sweden is the only Scandinavian country with treatment guidelines for BCC.
Eighty-six dermatologists from Sweden, Denmark, and Norway that were attending a meeting on photodynamic therapy were presented case history and clinical photographs of nine different BCCs and asked to select their treatment of choice among multiple options by the use of an electronic audience response system.
Treatment of choice differed substantially between dermatologists from the three countries. Swedish dermatologists more often chose excisional surgery (median 50%, range 0-90%) than their Danish (median 19%, range 0-44%) and Norwegian (median 35%, range 0-65%) colleagues. Very few Swedish dermatologists chose radiation therapy in the four cases where this was an option. Photodynamic therapy was more often selected by Norwegian dermatologists compared to Swedish and Danish dermatologists.
The treatment choices of Swedish dermatologists in cases of BCC are generally in line with Swedish treatment guidelines. National treatment guidelines for BCC should be established in all countries, including Denmark and Norway.
基底细胞癌（BCC）是一种具有局部破坏性的皮肤癌，主要影响白种人。BCC有多种治疗选择，其中切除手术应用最为广泛。治疗方法的选择可能取决于临床指南、当地治疗传统和/或个人经验。瑞典是斯堪的纳维亚半岛唯一有BCC治疗指南的国家。
来自瑞典、丹麦和挪威的86名皮肤科医生参加了一次光动力治疗会议，会上展示了9种不同BCC的病例史和临床照片，并要求他们通过电子观众反应系统从多种选择中选出他们的首选治疗方法。
三个国家的皮肤科医生首选的治疗方法有很大差异。瑞典皮肤科医生比丹麦（中位数19%，范围0 - 44%）和挪威（中位数35%，范围0 - 65%）的同行更常选择切除手术（中位数50%，范围0 - 90%）。在有放射治疗选择的4个病例中，很少有瑞典皮肤科医生选择放射治疗。与瑞典和丹麦皮肤科医生相比，挪威皮肤科医生更常选择光动力治疗。
瑞典皮肤科医生对BCC病例的治疗选择总体上符合瑞典治疗指南。包括丹麦和挪威在内的所有国家都应制定BCC的国家治疗指南。
