Megill Christina, Wilkin Timothy
Division of Infectious Diseases, Weill Cornell Medicine 53 W. 23 St. 6 Floor, New York, NY 10010, 212-746-7204 (phone), 212-746-7203 (fax).
Semin Colon Rectal Surg. 2017 Jun;28(2):86-90. doi: 10.1053/j.scrs.2017.04.006. Epub 2017 Apr 26.
Anal cancer may be prevented by treating anal high-grade squamous intraepithelial lesions (HSIL). Ablative therapies are the most commonly used treatments, but they may not be appropriate for all patients including those with extensive HSIL or bleeding diastheses. Researchers have studied topical therapies for human papillomavirus related lesions including anal HSIL. These therapies include patient-applied 5-fluorouracil, imiquimod and cidofovir, and provider-applied trichloroacetic acid. This review will discuss literature supporting efficacy of these products, which is based mainly on case series with few controlled trials having been conducted. Side effects are common with patient-applied topical therapy often requiring dose reduction and medication to treat pain. However, treatment discontinuations are infrequent. This review will also discuss some approaches to the use of these products in clinical practice.
通过治疗肛门高级别鳞状上皮内病变（HSIL）可预防肛门癌。消融疗法是最常用的治疗方法，但它们可能并不适用于所有患者，包括那些患有广泛HSIL或出血性疾病的患者。研究人员已经研究了针对人乳头瘤病毒相关病变（包括肛门HSIL）的局部治疗方法。这些治疗方法包括患者自行使用的5-氟尿嘧啶、咪喹莫特和西多福韦，以及医护人员使用的三氯乙酸。本综述将讨论支持这些产品疗效的文献，这些文献主要基于病例系列，很少有对照试验。患者自行使用局部治疗时副作用很常见，通常需要减少剂量并用药来治疗疼痛。然而，治疗中断情况并不常见。本综述还将讨论在临床实践中使用这些产品的一些方法。
