Soong Laura C, Keeling Christopher P
1 University of Alberta, Edmonton, AB, Canada.
2 Department of Medicine, Division of Dermatology, University of Alberta, Edmonton, AB, Canada.
J Cutan Med Surg. 2018 Jul/Aug;22(4):400-404. doi: 10.1177/1203475418758973. Epub 2018 Feb 18.
Superficial basal cell carcinoma (sBCC) and squamous cell carcinoma in situ (SCCis) are 2 types of nonmelanoma skin cancers (NMSCs) that are amenable to treatment with topical 5-fluorouracil, cryosurgery, or topical imiquimod, among other destructive and surgical modalities. There are few studies examining the effectiveness of combination therapy with 5% 5-fluorouracil and cryosurgery for the treatment of sBCC and SCCis.
Our objective was to study the clinical cure rate achieved with the regimen of cryosurgery and a 3-week course of 5% 5-fluorouracil in the treatment of biopsy-proven sBCC and SCCis.
A retrospective chart review of patients treated with cryosurgery and a 3-week course of 5% 5-fluorouracil was performed. Immunocompetent patients with biopsy-proven sBCC or SCCis who completed the treatment and attended a follow-up appointment at 6 months were included in the study.
On clinical examination, 30 sBCC lesions of the 34 that were assessed and 31 SCCis lesions of the 33 that were assessed demonstrated no evidence of recurrence. The clinical cure rates were found to be 73% (sBCC) and 82% (SCCis), with the inclusion of patients that were lost to follow-up.
This approach may represent a suitable option for select patients for the treatment of SCCis. Further studies with a longer follow-up duration, documentation of histologic cure, and tolerability of this regimen for SCCis are needed. The effectiveness of cryosurgery and 5-fluorouracil for sBCC requires further study.
浅表性基底细胞癌(sBCC)和原位鳞状细胞癌(SCCis)是两种非黑色素瘤皮肤癌(NMSCs),除其他破坏性和手术方式外,还可用外用5-氟尿嘧啶、冷冻手术或外用咪喹莫特治疗。很少有研究探讨5% 5-氟尿嘧啶与冷冻手术联合治疗sBCC和SCCis的有效性。
我们的目的是研究冷冻手术和为期3周的5% 5-氟尿嘧啶疗程治疗经活检证实的sBCC和SCCis所达到的临床治愈率。
对接受冷冻手术和为期3周的5% 5-氟尿嘧啶疗程治疗的患者进行回顾性病历审查。纳入经活检证实为sBCC或SCCis且免疫功能正常、完成治疗并在6个月时进行随访的患者。
临床检查发现,评估的34处sBCC病变中有30处以及评估的33处SCCis病变中有31处无复发迹象。包括失访患者在内,临床治愈率分别为73%(sBCC)和82%(SCCis)。
这种方法可能是治疗SCCis的部分患者的合适选择。需要进一步开展随访时间更长的研究,记录组织学治愈情况以及该方案对SCCis的耐受性。冷冻手术和5-氟尿嘧啶治疗sBCC的有效性需要进一步研究。