Bánvölgyi András, Lőrincz Kende, Kiss Norbert, Avci Pinar, Fésűs Luca, Szipőcs Róbert, Krenács Tibor, Gyöngyösi Nóra, Wikonkál Norbert, Kárpáti Sarolta, Németh Krisztián
Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary.
Wigner RCP, Institute for Solid State Physics and Optics, Budapest, Hungary.
Postepy Dermatol Alergol. 2020 Aug;37(4):548-558. doi: 10.5114/ada.2019.83027. Epub 2019 Feb 26.
The anti-cancer properties of high-dose intravenous ascorbic acid have been demonstrated in various malignancies. In our recent study, we tested topically applied ascorbic acid to treat basal cell carcinoma (BCC), and achieved a good clinical response.
Based on these results, we decided to examine the efficacy and tolerability of high-dose intravenous ascorbic acid (IVA) for locally advanced BCC.
In this pilot study, patients diagnosed with locally advanced BCC who were not amenable to radiation, surgical or local therapy (no other treatment option was available at the time) received intravenous ascorbic acid (1-1.8 g/kg), in an outpatient setting, 1-3 times per week for a mean duration of 42 ±23.6 weeks. This therapy was generally well tolerated.
Among 4 patients who had a total of 165 (mean: 41 ±51, range: 1-114) skin lesions, 3 patients achieved stable disease and one had progressive disease. There was substantial variability in individual tumor response to therapy. With the aid of two-photon microscopy and second harmonic generation imaging techniques, alterations in collagen structure were observed between tumor nests during IVA therapy.
Our results suggest that IVA is well tolerated in a small group of patients with extensive BCCs. However, in the era of smoothened (Smo) receptor inhibitors, it may only be considered as an adjuvant therapy in treatment-resistant cases.
高剂量静脉注射维生素C的抗癌特性已在多种恶性肿瘤中得到证实。在我们最近的研究中，我们测试了局部应用维生素C治疗基底细胞癌（BCC），并取得了良好的临床反应。
基于这些结果，我们决定研究高剂量静脉注射维生素C（IVA）治疗局部晚期基底细胞癌的疗效和耐受性。
在这项前瞻性研究中，被诊断为局部晚期基底细胞癌且不适合放疗、手术或局部治疗（当时没有其他治疗选择）的患者在门诊接受静脉注射维生素C（1-1.8 g/kg），每周1-3次，平均持续时间为42±23.6周。这种治疗一般耐受性良好。
4例患者共有165处（平均：41±51，范围：1-114）皮肤病变，其中3例病情稳定，1例病情进展。个体肿瘤对治疗的反应存在很大差异。借助双光子显微镜和二次谐波产生成像技术，在IVA治疗期间观察到肿瘤巢之间胶原蛋白结构的改变。
我们的结果表明，IVA在一小群患有广泛基底细胞癌的患者中耐受性良好。然而，在使用 smoothened（Smo）受体抑制剂的时代，它可能仅被视为治疗耐药病例的辅助治疗。
