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剥脱性分次激光联合外用氟尿嘧啶治疗浅表性基底细胞癌和原位鳞状细胞癌的随访研究

Ablative Fractional Laser-Assisted Topical Fluorouracil for the Treatment of Superficial Basal Cell Carcinoma and Squamous Cell Carcinoma In Situ: A Follow-Up Study.

作者信息

Hsu Sarah H, Gan Stephanie D, Nguyen Bichchau T, Konnikov Nellie, Liang Christine A

机构信息

*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.

出版信息

Dermatol Surg. 2016 Sep;42(9):1050-3. doi: 10.1097/DSS.0000000000000814.

Abstract

BACKGROUND

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).

OBJECTIVE

This follow-up study was conducted to assess whether tumor clearance was sustained in this cohort of patients at >9 months post-treatment.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

背景

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。

目的

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。

方法

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。

结果

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)。

结论

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。

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