Centre hospitalier universitaire de Québec-Université Laval, Quebec City, QC.
Western University, London, ON.
Curr Oncol. 2020 Aug;27(4):e399-e407. doi: 10.3747/co.27.6015. Epub 2020 Aug 1.
Non-melanoma skin cancers are the most prevalent form of cancer, with cutaneous squamous cell carcinoma (cscc) being the 2nd most common type. Patients presenting with high-risk lesions associated with locally advanced or metastatic cscc face high rates of recurrence and mortality. Accurate staging and risk stratification for patients can be challenging because no system is universally accepted, and no Canadian guidelines currently exist. Patients with advanced cscc are often deemed ineligible for either or both of curative surgery and radiation therapy (rt) and, until recently, were limited to off-label systemic cisplatin-fluorouracil or cetuximab therapy, which offers modest clinical benefits and potentially severe toxicity. A new systemic therapy, cemiplimab, has been approved for the treatment of locally advanced and metastatic cscc. In the present review, we provide recommendations for patient classification and staging based on current guidelines, direction for determining patient eligibility for surgery and rt, and an overview of the available systemic treatment options for advanced cscc and of the benefits of a multidisciplinary approach to patient management.
非黑色素瘤皮肤癌是最常见的癌症类型，皮肤鳞状细胞癌（cscc）是第二常见的类型。患有与局部晚期或转移性 cscc 相关的高危病变的患者复发和死亡的风险很高。由于没有普遍接受的系统，并且目前没有加拿大指南，因此对患者进行准确的分期和风险分层具有挑战性。晚期 cscc 患者通常被认为不适合进行根治性手术和放疗（rt），并且直到最近，他们仅限于标签外的全身顺铂-氟尿嘧啶或西妥昔单抗治疗，这种治疗提供适度的临床益处和潜在的严重毒性。一种新的全身性治疗药物，西米普利单抗，已被批准用于治疗局部晚期和转移性 cscc。在本综述中，我们根据当前指南提供了患者分类和分期的建议，为确定手术和 rt 患者的资格提供了指导，并概述了晚期 cscc 的可用全身治疗选择以及多学科方法治疗患者的益处。
