使用0.05%的鬼臼毒素酯凝胶治疗浅表性基底细胞癌。
Treatment of superficial basal cell carcinoma with ingenol mebutate gel, 0.05%.
作者信息
Bettencourt Miriam S
机构信息
Advanced Dermatology and Cosmetic Surgery, Henderson; Department of Dermatology, University of Nevada, Las Vegas, NV, USA.
出版信息
Clin Cosmet Investig Dermatol. 2016 Aug 16;9:205-9. doi: 10.2147/CCID.S109531. eCollection 2016.
BACKGROUND
Basal cell carcinoma (BCC) is the most common cancer in Caucasians. Surgical approaches are the most widely used and effective treatment strategies for well-defined BCC. However, for patients with low-risk, superficial BCCs (sBCCs), medical therapy may be a treatment option. In this small case series, we describe our experience in using topical treatment with ingenol mebutate gel, 0.05%, for patients who refused surgical treatment for sBCC.
METHODS
We conducted a retrospective chart review of seven patients from our community dermatology practice for whom sBCC was treated with ingenol mebutate. The chart review extracted information on demography, dermatologic history, and prior treatment for actinic keratosis or skin cancer. Summary of the treatment outcome with ingenol mebutate included the size and location of the sBCCs, description of administration, local skin reactions, adverse events, and efficacy.
RESULTS
Histopathologic analysis of a shave biopsy sample of suspicious lesions on the trunk confirmed nine sBCCs: a single sBCC in five patients and two well-separated lesions in each of the other two patients. Patients were treated at 10 to 14 days after shave biopsy; biopsy sites were not required to be fully healed. Lesions were either occluded using a standard adhesive bandage (n=6) or not occluded (n=3). All patients experienced local skin reactions that began on day 1 or 2 of treatment, peaked on days 2 to 7, and were largely resolved at 2 weeks. All sBCCs were clinically resolved on short-term follow-up at 2 to 4 weeks. Repeat biopsy of six lesion sites in four patients at 3 or 4 months confirmed histologic clearance. There were no clinically suspicious lesions in any patients at subsequent follow-up evaluations at 3-month intervals. The longest follow-up to date has been 14 months.
CONCLUSION
Ingenol mebutate gel, 0.05%, was efficacious and well tolerated for the treatment of biopsy-confirmed sBCCs on the trunk in seven patients.
背景
基底细胞癌（BCC）是白种人中最常见的癌症。手术方法是治疗边界清晰的BCC最广泛使用且有效的治疗策略。然而，对于低风险的浅表性BCC（sBCC）患者，药物治疗可能是一种治疗选择。在这个小病例系列中，我们描述了使用0.05%的鬼臼毒素酯凝胶进行局部治疗的经验，这些患者因sBCC而拒绝手术治疗。
方法
我们对社区皮肤科诊所的7例接受鬼臼毒素酯治疗sBCC的患者进行了回顾性病历审查。病历审查提取了人口统计学、皮肤病史以及光化性角化病或皮肤癌既往治疗情况的信息。鬼臼毒素酯治疗结果总结包括sBCC的大小和位置、给药描述、局部皮肤反应、不良事件及疗效。
结果
对躯干上可疑病变的刮除活检样本进行组织病理学分析，证实有9个sBCC：5例患者各有1个sBCC，另外2例患者各有2个分隔良好的病变。患者在刮除活检后10至14天接受治疗；活检部位无需完全愈合。病变要么用标准粘性绷带覆盖（n = 6），要么不覆盖（n = 3）。所有患者均出现局部皮肤反应，在治疗第1或2天开始，第2至7天达到高峰，2周时基本消退。所有sBCC在2至4周的短期随访中临床治愈。4例患者中6个病变部位在3或4个月时重复活检证实组织学清除。在随后每3个月的随访评估中，任何患者均无临床可疑病变。迄今为止最长的随访时间为14个月。
结论
0.05%的鬼臼毒素酯凝胶对7例躯干上经活检证实的sBCC患者治疗有效且耐受性良好。
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