Long-term experience with radiotherapy for the treatment of non-melanoma skin cancer.
- 作者列表："Visch Marjolein Birgitte MB","Kreike Bas B","Gerritsen Marie-Jeanne Pieternel MJP
:Purpose: In the Netherlands, the incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin is increasing dramatically. Radiotherapy is one of the treatment options, especially for the high risk and the irradical excised tumours.Methods: Retrospectively, the treatment outcome of all patients with BCC or SCC treated with radiotherapy in the period 2000-2013, were reviewed. Patients were divided into two groups, i.e. patients primarily treated with radiotherapy (n = 583) and patients with adjuvant radiation after irradical surgical excision (n = 140).Results: With respect to the treatment outcome, after a median follow-up of 3.4 years for the primarily treated BCCs, 6.5% of the tumours recurred (3-year local control rate for stage I: 93.3% and stage II: 94.4%). 12.7% of the primarily treated SCCs recurred after a median follow-up of 2.4 years (3-year local control rate for stage I: 92.0% and stage II: 83.7%). Local recurrence rates for post-operatively irradiated tumours were 3.6% for BCCs and 11.5% for SCCs.Discussion: The yearly number of patients with BCC or SCC treated with radiotherapy does not reflect the increasing incidence of these tumours. Radiotherapy has potential good treatment outcome in terms of local control and toxicity and seem to be predominantly chosen for tumours located in the head-and-neck area.
目的: 在荷兰，皮肤基底细胞癌 (BCC) 和鳞状细胞癌 (SCC) 的发病率急剧增加。放射治疗是治疗选择之一，特别是对于高风险和不可根治的切除肿瘤。方法: 回顾性分析 2000 ~ 2013 年间接受放射治疗的所有BCC或SCC患者的治疗结果。患者分为两组，即放疗初治患者 (n = 583) 和根治性手术切除后辅助放疗患者 (n = 140)。结果: 关于治疗结果，经过中位随访 3。4 年初治BCCs，6.5% 的肿瘤复发 (ⅰ 期 3 年局部控制率: 9 3。3% 和第二阶段: 94.4%)。12.7% 的初始治疗SCCs在中位随访 2.4 年后复发 (I期的 3 年局部控制率: 92.0%，II期的 3 年局部控制率: 7%)。术后照射肿瘤的局部复发率BCCs为 3.6%，SCCs为 11.5%。讨论: 每年接受放疗的BCC或SCC患者数量并不反映这些肿瘤发病率的增加。放疗在局部控制和毒性方面具有潜在的良好治疗结果，似乎主要用于位于头颈部的肿瘤。
METHODS::Blue rubber bleb naevus syndrome (BRBNS) is an extremely rare venous malformation that often manifests as multiple haemangioma-like lesions in the skin and gastrointestinal tract. The drug sirolimus plays a key role in the signalling pathway of angiogenesis and subsequent development of BRBNS and its use has been described in several case reports. We present a case series of four patients with BRBNS who exhibited good treatment response to sirolimus. All four patients were administered oral sirolimus at doses of 1.0-1.5 mg/m2 /day with a target drug level of 5-10 ng/mL and median treatment duration of 20 months. All patients had a reduction in the size of the lesions and a normalization of coagulopathy with tolerable drug adverse reactions at follow-up. Sirolimus may be effective and safe in paediatric patients with BRBNS. Further prospective studies are suggested to evaluate the long-term effectiveness of this drug.
METHODS:BACKGROUND:Human papillomavirus (HPV) infections are associated with common dermatologic and nondermatologic diseases. Although HPV vaccines are well established as preventive measures for genital warts and cervical neoplasia, their use as therapeutic agents deserves greater attention. OBJECTIVE:To evaluate the use of HPV vaccine(s) as a treatment modality for cutaneous and/or mucosal disease. METHODS:A primary literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted in January 2019 by using the PubMed and Cochrane databases. RESULTS:A total of 63 articles with 4439 patients were included. The majority of patients with cutaneous warts, recurrent respiratory papillomatosis, and squamous and basal cell carcinomas were successfully treated with HPV vaccination. Preliminary data on patients with pre-existing anogenital warts, cervical intraepithelial neoplasia, anal intraepithelial neoplasia, and vulvar intraepithelial neoplasia is promising. LIMITATIONS:This review was limited by the lack of controls, patients' previous HPV vaccination status, and publication bias. CONCLUSION:The commercially available three-dose, quadrivalent HPV vaccine is a potential therapeutic option for the treatment of cutaneous warts, recurrent respiratory papillomatosis, and squamous and basal cell carcinomas. Noncommercially available HPV vaccines demonstrate therapeutic response for treating anogenital warts, cervical intraepithelial neoplasia, anal intraepithelial neoplasia, and vulvar intraepithelial neoplasia. The vaccine's efficacy as an adjunct therapy for HPV-associated cutaneous and/or mucosal disease warrants further exploration.
METHODS::Our understanding of melanoma precursors and progression to melanoma has developed as a result of advances in the field of molecular diagnostics. We now better understand the potential for genetic heterogeneity within a single lesion. Combined tumors can pose a diagnostic challenge when deciding the line between benign and malignant, which in turn has direct implications for patient management. Primary cilia (PC) are ubiquitous sensory organelles that have essential functions in cellular proliferation, differentiation, and development. The ciliation index (percentage of ciliated melanocytes) has been shown to reliably differentiate melanoma, which fail to ciliate, from melanocytic nevi, which retain PC. We therefore analyzed the potential for using the ciliation index to differentiate benign and malignant components in combined melanocytic lesions. We collected patient samples (n = 10) of unequivocal combined lesions with both melanoma and associated nevus components. Melanocytes were highlighted with SOX10 and costained with gamma-Tubulin and acetylated alpha-Tubulin to highlight the basal body and cilium, respectively. The number of melanocytes retaining cilia under high-power microscopy was examined. The melanoma component had average of 4% ciliation (SD: 7%), whereas the associated nevus component was significantly higher with 59% ciliation (SD: 17%). These data show that PC may be a reliable means of distinguishing benign from malignant components within a single tumor. The ciliation index may be a helpful tool in distinguishing challenging cases of combined lesions of melanoma in situ with a dermal nevus component from invasive melanoma, thus promoting improved staging and clinical management.