Čeović Romana, Petković Mikela, Mokos Zrinka Bukvić, Kostović Krešimir
Department of Dermatology and Venereology, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia.
Policlinic Nola, Zagreb, Croatia.
Clin Dermatol. 2018 Mar-Apr;36(2):177-187. doi: 10.1016/j.clindermatol.2017.10.009. Epub 2017 Nov 3.
Nonmelanoma skin cancer (NMSC) is the most common cancer, with the median age at NMSC diagnosis is 71 years. Treatment options for NMSC include surgical therapy, which is usually the first-choice treatment, and nonsurgical modalities. Therapeutic modalities depend on tumor localization, histologic type, and biologic behavior, as well as patient comorbidities, age, and life expectancy. Nonsurgical treatments include cryotherapy, local therapies (imiquimod, 5-fluorouracil, ingenol mebutate, and diclofenac), photodynamic therapy, radiotherapy, and hedgehog inhibitors. Some of these treatments can be combined with curettage and electrodesiccation for better outcomes. Every treatment modality has advantages and disadvantages that must be carefully considered individually. Because the facial area is the most common localization of NMSC, treatment modalities with better cosmetic outcome are preferred. Although NMSC mostly occurs in the elderly, this review is focused on the features and nonsurgical therapy of NMSC in deep old age (≥85) and long-lived persons (aged >95); however, clinical trials very rarely involve this population group due to poor cooperation or poor general condition of these patients; thus, the respective knowledge being generally based on clinical experience.
非黑色素瘤皮肤癌（NMSC）是最常见的癌症，NMSC诊断时的中位年龄为71岁。NMSC的治疗选择包括手术治疗（通常是首选治疗方法）和非手术治疗方式。治疗方式取决于肿瘤的部位、组织学类型、生物学行为，以及患者的合并症、年龄和预期寿命。非手术治疗包括冷冻疗法、局部治疗（咪喹莫特、5-氟尿嘧啶、鬼臼毒素酊和双氯芬酸）、光动力疗法、放射疗法和刺猬抑制剂。其中一些治疗可与刮除术和电干燥法联合使用以获得更好的效果。每种治疗方式都有其优缺点，并必须分别仔细考虑。由于面部是NMSC最常见的发病部位，因此更倾向于选择具有更好美容效果的治疗方式。虽然NMSC大多发生在老年人中，但本综述重点关注高龄（≥85岁）和长寿者（年龄>95岁）NMSC的特征和非手术治疗；然而，由于这些患者合作性差或一般状况不佳，临床试验很少涉及这一人群；因此，相关知识通常基于临床经验。
