Kakkassery Vinodh, Emmert Steffen, Adamietz Irenäus A, Kovács György, Jünemann Anselm M, Otte Caroline, Zimbelmann Michael, Brosig Anton, Grisanti Salvatore, Heindl Ludwig M
Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
Klinik und Poliklinik für Dermatologie, Universitätsmedizin Rostock, Rostock, Deutschland.
Ophthalmologe. 2020 Feb;117(2):113-123. doi: 10.1007/s00347-019-01021-4.
Latest developments as well as established procedures offer alternative treatment approaches to basal cell carcinoma (BCC) when micrographically controlled surgical removal is not a valid option.
Alternative treatment options for periorbital BCC are presented.
A literature search was carried out and a structured display and analysis of the results are given.
Micrographically controlled surgical removal represents the gold standard in treatment of BCC. When for various reasons surgical removal is not a valid option, other procedures are required. The alternative treatment options can be divided into three main groups: treatment options for locally advanced or metastasized BCC, topical approaches for small and superficial BCC and prophylactic measures. While radiotherapy and systemic therapy are suitable for locally advanced BCC and are discussed in a tumor board, small and superficial BCC can be treated by topical medication. In cases of a previous BCC history, a prophylactic treatment can be considered. Combinations of systemic treatment and also neoadjuvant or adjuvant approaches before and after surgery are promising options for a successful outcome, which can further improve the standard treatment for locally advanced BCC.
Alternative treatment options for periocular BCC are available; however, the use is only indicated when microscopically controlled excision with subsequent oculoplastic reconstruction is not possible. According to the national guidelines a prior presentation to a suitable tumor board is practically compulsory.
当显微控制手术切除不是有效的选择时,最新进展以及既定程序为基底细胞癌(BCC)提供了替代治疗方法。
介绍眶周基底细胞癌的替代治疗选择。
进行文献检索并对结果进行结构化展示与分析。
显微控制手术切除是基底细胞癌治疗的金标准。当由于各种原因手术切除不是有效的选择时,需要其他程序。替代治疗选择可分为三大类:局部晚期或转移性基底细胞癌的治疗选择、小而浅表性基底细胞癌的局部治疗方法以及预防措施。放疗和全身治疗适用于局部晚期基底细胞癌,并在肿瘤委员会中进行讨论,小而浅表性基底细胞癌可通过局部用药治疗。对于既往有基底细胞癌病史的患者,可考虑进行预防性治疗。全身治疗的联合以及手术前后的新辅助或辅助方法是有望取得成功结果的选择,这可以进一步改善局部晚期基底细胞癌的标准治疗。
眶周基底细胞癌有替代治疗选择;然而,仅在无法进行显微控制切除并随后进行眼整形重建时才使用。根据国家指南,事先向合适的肿瘤委员会报告实际上是强制性的。