Hsu Sarah H, Gan Stephanie D, Nguyen Bichchau T, Konnikov Nellie, Liang Christine A
*Department of Dermatology, Boston Medical Center, Boston University, Boston, Massachusetts; †Department of Dermatology, University of Michigan, Ann Arbor, Michigan; ‡Department of Dermatology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts; §Division of Dermatology, Veterans Affairs-Boston Hospitals, Boston Medical Center, Boston University, Boston, Massachusetts; ‖ Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Dermatol Surg. 2016 Sep;42(9):1050-3. doi: 10.1097/DSS.0000000000000814.
The authors previously reported the safety and short-term efficacy of ablative fractional laser (AFXL)-assisted delivery of topical fluorouracil in the treatment of superficial basal cell carcinoma (sBCC) and squamous cell carcinoma in situ (SCCis).
This follow-up study was conducted to assess whether tumor clearance was sustained in this cohort of patients at >9 months post-treatment.
Thirty primary sBCC or SCCis <2 cm on the trunk or extremities were treated with AFXL and a single application of topical 5-fluorouracil 5% under occlusion for 7 days. Among the 26 patients who achieved tumor clearance at 4 to 8 weeks post-treatment, 20 patients presented for this follow-up study and underwent shave biopsy to confirm histologic clearance. Mean follow-up time was 15 months.
Considering those who had persistent tumor at 4 to 8 weeks post-treatment and those who presented for follow-up at >9 months post-treatment, overall treatment success was 79% (95% confidence interval: 67%-96%), with 92% (11/12) for SCCis and 67% (8/12) for sBCC. Neither the tumor location nor size significantly impacted treatment outcome (p = .96 and 0.87, respectively).
Ablative fractional laser-assisted topical fluorouracil is a reasonable noninvasive treatment option for primary SCCis and sBCC, especially for lesions located in areas where self-application is not possible, or when clinician-administered therapy is preferred.
作者之前报道了剥脱性点阵激光(AFXL)辅助外用氟尿嘧啶治疗浅表基底细胞癌(sBCC)和原位鳞状细胞癌(SCCis)的安全性和短期疗效。
本随访研究旨在评估该队列患者在治疗后9个月以上肿瘤清除情况是否持续。
对30例躯干或四肢直径<2 cm的原发性sBCC或SCCis患者,采用AFXL治疗,并外用5%氟尿嘧啶单次封包7天。在治疗后4至8周实现肿瘤清除的26例患者中,20例患者参加了本随访研究,并接受了削切活检以确认组织学清除。平均随访时间为15个月。
综合治疗后4至8周仍有持续性肿瘤的患者以及治疗后9个月以上参加随访的患者,总体治疗成功率为79%(95%置信区间:67%-96%),其中SCCis为92%(11/12),sBCC为67%(8/12)。肿瘤位置和大小均未对治疗结果产生显著影响(p值分别为0.96和0.87)。
剥脱性点阵激光辅助外用氟尿嘧啶是原发性SCCis和sBCC合理的非侵入性治疗选择,尤其适用于无法自行用药的部位的病变,或更倾向于由临床医生进行治疗的情况。