Maranda Eric L, Nguyen Austin H, Lim Victoria M, Shah Vidhi V, Jimenez Joaquin J
Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave, Miami, FL, 33136, USA.
Creighton University School of Medicine, Omaha, NE, USA.
Lasers Med Sci. 2016 Dec;31(9):1971-1976. doi: 10.1007/s10103-016-2005-9. Epub 2016 Jun 21.
Erythroplasia of Queyrat (EOQ) is a squamous cell carcinoma in situ most commonly located on the glans penis or prepuce. EOQ accounts for roughly 10 % of all penile malignancies and may lead to invasive squamous cell carcinoma. Standard therapy includes local excision, partial or total penectomy, cryotherapy, and topical cytotoxic agents. Treatment of EOQ has proven to be challenging due to low response rates and recurrence. In addition, radical procedures can significantly affect sexual function and quality of life. Alternative laser treatments and photodynamic therapy (PDT) offer promising results for treating EOQ. A systemic review of the literature was performed for articles discussing laser and light therapy for EOQ. Among the patients treated with the CO laser, 81.4 % of cases had complete remission after one session of treatment. Patients treated with PDT presented with more variable results, where 62.5 % of those treated with methyl aminolevulinate photodynamic therapy (MAL-PDT) achieved complete remission. Aminolevulinic acid (ALA-PDT) treatment showed a similar rate of remission at 58.3 %. One study utilized the Nd:YAG laser, which resulted in a recurrence of the lesion in four of the five patients treated. Of the methods reviewed, the CO laser offered the most promising results with a cosmetically excellent prognosis. Further studies with larger power and longer follow-up times are needed to determine the optimal treatment regimen for this penile malignancy.
凯腊增殖性红斑(EOQ)是一种原位鳞状细胞癌,最常见于阴茎头或包皮。EOQ约占所有阴茎恶性肿瘤的10%,可能会发展为浸润性鳞状细胞癌。标准治疗方法包括局部切除、部分或全阴茎切除术、冷冻疗法以及局部细胞毒性药物。由于缓解率低和复发率高,EOQ的治疗已被证明具有挑战性。此外,根治性手术会显著影响性功能和生活质量。替代性激光治疗和光动力疗法(PDT)为治疗EOQ提供了有前景的结果。我们对文献进行了系统回顾,以查找讨论EOQ激光和光疗的文章。在接受CO激光治疗的患者中,81.4%的病例在一次治疗后完全缓解。接受PDT治疗的患者结果差异更大,其中接受甲基氨基酮戊酸光动力疗法(MAL-PDT)治疗的患者中有62.5%实现了完全缓解。氨基酮戊酸(ALA-PDT)治疗的缓解率与之相似,为58.3%。一项研究使用了Nd:YAG激光,在接受治疗的五名患者中,有四名患者出现了病变复发。在所回顾的方法中,CO激光的效果最有前景,预后美观。需要进一步开展更大样本量和更长随访时间的研究,以确定这种阴茎恶性肿瘤的最佳治疗方案。