浅表放疗治疗唇部非黑色素瘤皮肤癌: 意大利 44 年经验。
- 作者列表："Piccinno R","Tavecchio S","Benzecry V
:Background: Radiotherapy is a valuable therapeutic option for the treatment of non-melanoma skin cancer (NMSC) in the ageing population, in non-surgical candidates, or when the tumor is extensive or localized in a cosmetically sensitive area such as the lips.Objective: We report our 44-year experience in treating basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the vermilion lip using superficial radiotherapy.Methods: Forty-seven patients with biopsy-proven BCC or SCC of the lip were retrospectively reviewed. All patients had been treated with superficial radiotherapy in our unit, as a primary treatment or with adjuvant and salvage purposes. Lymph-node involvement at presentation was negative in all patients.Results: Local disease control was achieved in 91% of cases. Cure rates of 85% were obtained at 5 and 10 years. Four patients presented local tumor recurrence and only one patient developed lymphatic involvement. Cosmetic outcome was good in the majority of cases, and all patients, except for one, fully preserved the vermilion lip functionality.Conclusions: Our findings confirm that superficial radiotherapy is an effective treatment for early BCC or SCC of the vermilion lip, especially in the ageing population, in high-risk tumors, and even if poor cosmetic outcome is expected from surgical excision.
背景: 放射治疗是治疗非黑色素瘤皮肤癌 (NMSC) 的一种有价值的治疗选择，在老龄化人群中，在非手术候选者中，或者当肿瘤广泛或局限于美容敏感区域如嘴唇时。目的: 我们报告我们 44 年治疗基底细胞癌 (BCC) 的经验方法: 对 47 例经活检证实为唇部BCC或SCC的患者进行回顾性分析。所有患者均在我单位接受过浅表放疗，作为主要治疗或辅助挽救。所有患者就诊时淋巴结受累均为阴性。结果: 91% 的病例实现了局部疾病控制。治愈率 8 5%，获得了在 5 到 10 年的.4 例患者出现局部肿瘤复发，仅 1 例患者出现淋巴受累。大多数病例的美容效果良好，除 1 例外，所有患者都完全保留了红唇功能。结论: 我们的研究结果证实，浅表放疗是治疗唇红唇早期BCC或SCC的有效治疗方法，尤其是在老龄化人群中，在高危肿瘤中，即使手术切除的美容效果不佳。
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.