Leshin B, Yeatts P, Anscher M, Montano G, Dutton J J
Department of Dermatology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina.
Surv Ophthalmol. 1993 Sep-Oct;38(2):193-212. doi: 10.1016/0039-6257(93)90101-c.
In treating periocular basal cell carcinoma the goal is to achieve the most complete eradication of affected tissue while preserving as much healthy tissue as possible. In the first of these "Viewpoints" articles, Drs. Leshin and Yeatts discuss the success of Mohs' microsurgical technique (MMS) in both regards. Moreover, they note that MMS offers the additional advantage of placing all surgical and histological phases of tumor excision in the hands of one specialist, thus circumventing problems that may arise with procedures requiring the separate involvement of several specialists. In the second article, Drs. Anscher and Montana point out that modern radiotherapy techniques may offer adequate tumor control with less damage to surrounding tissues than is caused by surgical excision and reconstruction. With small lesions, radiotherapy has a success rate similar to that of surgery. With large lesions, the success rate is lower; however, if surgical excision would cause extensive disfigurement or functional damage, an initial trial of radiotherapy may be warranted, then followed by surgery, if necessary. In an editorial, Dr. Dutton summarizes the indications for and advantages and disadvantages of both techniques.
在治疗眼周基底细胞癌时，目标是在尽可能保留健康组织的同时，实现对病变组织的最彻底清除。在这些“观点”文章的第一篇中，莱申博士和耶茨博士讨论了莫氏显微外科技术（MMS）在这两方面的成功之处。此外，他们指出，MMS还具有额外的优势，即肿瘤切除的所有手术和组织学阶段都由一名专家负责，从而避免了需要多名专家分别参与的手术可能出现的问题。在第二篇文章中，安舍尔博士和蒙大拿博士指出，现代放疗技术可能在对周围组织造成比手术切除和重建更小损伤的情况下，实现足够的肿瘤控制。对于小病变，放疗的成功率与手术相似。对于大病变，成功率较低；然而，如果手术切除会导致广泛的毁容或功能损害，则可能有必要先进行放疗试验，如有必要，随后再进行手术。在一篇社论中，达顿博士总结了这两种技术的适应症以及优缺点。
