Dermatology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Biostatistics Department, Hospital Universitario La Paz, Madrid, Spain.
Dermatol Ther. 2022 Feb;35(2):e15233. doi: 10.1111/dth.15233. Epub 2021 Dec 27.
Intralesional methotrexate (il-MTX) has been used in cutaneous squamous cell carcinoma (cSCC) achieving important reductions in tumor size. However, there is a lack of controlled studies on this regard. The primary objective was to analyze the effect of il-MTX on tumor size in cSCC. As a secondary objective, we evaluated its impact on the surgical approach. We conducted a prospective cohorts study that included 200 patients with histologically confirmed cSCC. Patients in Group 1 (Cases) received neoadjuvant treatment with il-MTX prior to surgery. Patients in Group 2 (Controls) underwent scheduled surgery without prior neoadjuvant therapy. Clinical measurements of lesions were made at the time of inclusion in the study and before surgery. No intergroup statistical differences were found between the assessed variables. In Group 1, tumor size reduction occurred in 93% of the patients after il-MTX therapy. Tumor surface was reduced by 54%. Complex reconstructions were needed in 15% of these patients. In Group 2, tumor surface increased by 33.1% and complex reconstructions were needed in 40% of patients. Intergroup differences were statistically significant (p < 0.001). Neoadjuvant Il-MTX therapy achieves very important tumor size reduction and significantly simplifies surgical treatment.
瘤内甲氨蝶呤（il-MTX）已被用于治疗皮肤鳞状细胞癌（cSCC），可显著缩小肿瘤体积。然而，在这方面缺乏对照研究。主要目的是分析 il-MTX 对 cSCC 肿瘤大小的影响。次要目的是评估其对手术方式的影响。我们进行了一项前瞻性队列研究，纳入了 200 例经组织学证实的 cSCC 患者。第 1 组（病例组）患者在手术前接受 il-MTX 新辅助治疗。第 2 组（对照组）患者接受计划手术，无术前新辅助治疗。在研究纳入时和手术前对病变进行临床测量。评估变量在组间无统计学差异。在第 1 组中，il-MTX 治疗后 93%的患者肿瘤体积缩小。肿瘤表面减少了 54%。这些患者中有 15%需要进行复杂的重建。在第 2 组中，肿瘤表面增加了 33.1%，40%的患者需要进行复杂的重建。组间差异具有统计学意义（p<0.001）。新辅助 Il-MTX 治疗可显著缩小肿瘤体积，显著简化手术治疗。
