Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petah-Tiqva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Dermatology. 2022;238(1):161-166. doi: 10.1159/000515496. Epub 2021 Apr 26.
Keratinocyte carcinomas, particularly squamous cell carcinoma (SCC), occur more frequently and aggressively in solid-organ transplant recipients (SOTRs) than in the general population. Systemic retinoids are effective in secondary prevention of keratinocyte carcinomas in this population, but their use is limited by adverse effects including a rebound effect in cases of treatment discontinuation.
Our aim was to determine whether low-dose acitretin is efficient in the secondary prevention of keratinocyte carcinomas in SOTRs.
This retrospective case-crossover study was conducted at a specialized dermatology clinic for SOTRs in a large transplantation center in 2010-2017. Patients with at least 1 previous keratinocyte carcinoma who were treated with acitretin 10 mg/day for 2 years were included. The main outcome was the difference in the number of new keratinocyte carcinomas diagnosed during treatment compared to during the 2-year pretreatment period.
The cohort included 34 SOTRs. A significant reduction in the mean number of new keratinocyte carcinomas during treatment relative to the pretreatment period was observed (1.7 vs. 3.6, -53% p = 0.002). Similar results were noted on analysis by tumor type, for both SCC and basal cell carcinoma.
This study of SOTRs demonstrated positive results for low-dose acitretin as a chemoprevention of keratinocyte carcinomas in this population.
与普通人群相比，实体器官移植受者（SOTR）的角质形成细胞癌（尤其是鳞状细胞癌[SCC]）发生更频繁且侵袭性更强。全身性维甲酸在该人群中角质形成细胞癌的二级预防中有效，但由于不良反应（包括治疗停止后的反弹效应），其使用受到限制。
我们旨在确定低剂量阿维 A 酯是否能有效预防 SOTR 角质形成细胞癌的发生。
这是一项 2010-2017 年在大型移植中心的专门 SOTR 皮肤科诊所进行的回顾性病例交叉研究。纳入了至少有 1 次既往角质形成细胞癌病史且接受阿维 A 酯 10mg/天治疗 2 年的患者。主要结局为治疗期间与 2 年预处理期间诊断的新发角质形成细胞癌数量的差异。
该队列纳入了 34 名 SOTR。与预处理期相比，治疗期间新发角质形成细胞癌的平均数量显著减少（1.7 比 3.6，减少 53%，p=0.002）。通过对 SCC 和基底细胞癌两种肿瘤类型的分析，也得到了类似的结果。
这项对 SOTR 的研究表明，低剂量阿维 A 酯作为该人群角质形成细胞癌的化学预防具有积极效果。
