Mathis Jason, Doerr Timothy, Lin Edward, Ibrahim Sherrif F
*All authors are affiliated with the University of Rochester Medical Center, Rochester, New York.
All authors are affiliated with the University of Rochester Medical Center, Rochester, New York.
Dermatol Surg. 2019 Jan;45(1):17-25. doi: 10.1097/DSS.0000000000001640.
Basal cell cancer is the most common cutaneous malignancy. It rarely presents with locally advanced or metastatic disease. Rare presentations such as intraorbital invasion remain a difficult clinical problem with significant potential morbidity. There is no review of sonic hedgehog pathway inhibitors (HPIs) for intraorbital basal cell cancer, and evidence regarding optimal management is limited.
To evaluate the evidence for the management of intraorbital basal cell cancer with HPIs.
A search to identify evidence for treatment intraorbital basal cell cancers with HPIs to date was performed in PubMed database and OVID using the phrases "basal cell cancer/carcinoma/BCC," "intraorbital," "orbital," "ocular," "periocular," "vismodegib," "GDC-0449," "sonidegib," and "LDE224," in various combinations with Boolean operators "AND" and "OR."
Rigorous clinical trials have previously reported the use of vismodegib and sonidegib in locally advanced and metastatic basal cell carcinoma (BCC). However, specific descriptions of treatment of intraorbital tumors are rarely presented in detail adequate for analysis. Twenty-two cases of intraorbital BCC treated with vismodegib have been described in the literature, and no cases using sonidegib were identified. These vary in quality, but highlight important questions regarding optimal treatment duration, follow-up, and adjunctive therapies. Reports describing locally advanced BCC in various facial and periocular locations, but without specific mention of intraorbital invasion, were excluded.
Vismodegib is an attractive eye and vision-sparing option in patients with locally advanced intraorbital basal cell cancer whose other options often include exenteration, radiation, or other radical surgery.
基底细胞癌是最常见的皮肤恶性肿瘤。它很少表现为局部晚期或转移性疾病。罕见的表现如眶内侵犯仍然是一个具有重大潜在发病率的棘手临床问题。目前尚无关于眶内基底细胞癌的音猬因子通路抑制剂（HPIs）的综述，且关于最佳治疗方案的证据有限。
评估使用HPIs治疗眶内基底细胞癌的证据。
在PubMed数据库和OVID中进行检索，以识别迄今为止使用HPIs治疗眶内基底细胞癌的证据，检索词为“基底细胞癌/癌/BCC”、“眶内”、“眼眶”、“眼部”、“眼周”、“维莫德吉”、“GDC - 0449”、“索尼德吉”和“LDE224”，并使用布尔运算符“AND”和“OR”进行各种组合。
严格的临床试验此前已报道维莫德吉和索尼德吉用于局部晚期和转移性基底细胞癌（BCC）。然而，很少有关于眶内肿瘤治疗的具体描述详细到足以进行分析。文献中描述了22例使用维莫德吉治疗的眶内BCC病例，未发现使用索尼德吉的病例。这些病例质量参差不齐，但突出了关于最佳治疗持续时间、随访和辅助治疗的重要问题。描述各种面部和眼周部位局部晚期BCC但未特别提及眶内侵犯的报告被排除。
对于局部晚期眶内基底细胞癌患者，维莫德吉是一种有吸引力的保眼和视力的选择，因为其其他选择通常包括眶内容摘除术、放疗或其他根治性手术。
