Long-term follow-up of skin cancer in the PUVA-48 cooperative study

Forman, A. B.

doi:10.1001/archderm.125.4.515

Cited by 31 publications

(26 citation statements)

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“…The median cumulative PUVA dose was 70.5 J/cm 2 in the other 4 patients and was similar to the median cumulative dose of 67.5 J/cm 2 in the whole cohort. The incidence of cutaneous SCC is significantly higher in our cohort than that reported in a study 7 of 551 patients with psoriasis treated with PUVA, although the mean cumulative PUVA dose in the patients with psoriasis was much greater (3015 J/cm 2 ). Another study 12 of 246 patients who received PUVA, a median cumulative dose of 654 J/cm 2 , reported a risk of nonmelanoma skin cancer 1.4 times greater than in the United Kingdom population.…”

Section: P Revious Studiescontrasting

confidence: 75%

“…5 We reviewed the incidence of secondary malignant neoplasms in our patients with SS. We compared the incidence of SCC in the cohort with the incidence in a study 6 of an aged-matched population in England, patients with psoriasis treated with high-dose PUVA, 7 and a study 2 conducted in England of renal transplant recipients. We also compared the number of internal malignant neoplasms with those occurring in patients who were treated for Hodgkin lymphoma.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of cutaneous SCC in the patients with SS was compared with the incidence in age-matched patients, 6 renal transplant recipients, 2 and patients with psoriasis who had received PUVA therapy. 7 The Poisson distribution was used to calculate the statistical significance.…”

Section: Methodsmentioning

confidence: 99%

“…The median cumulative PUVA dose of the other 4 patients was 70.5 J/cm 2 in 52 treatments, similar to the median PUVA dose of 67.5 J/cm 2 in 40 treatments received by patients in the total cohort who did not develop cutaneous SCCs. A study 7 of 551 patients with psoriasis treated with PUVA observed 9 cutaneous SCCs during a 10-year follow-up, which is an incidence of 350 per 1 ϫ 10 5 person-years. This incidence is significantly lower than the incidence of cutaneous SCC in our cohort, which was 1657 per 1 ϫ 10 5 person-years (P = .001; CI, 626-2856), although the mean cumulative PUVA dose in the patients with psoriasis who developed SCCs was 3015 J/cm 2 compared with only 70.5 J/m 2 in our group.…”

Section: Methodsmentioning

confidence: 99%

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Secondary Malignant Neoplasms in 71 Patients With Sézary Syndrome

Scarisbrick

Child²,

Evans³

et al. 1999

Arch Dermatol

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Background: Sézary syndrome (SS) is characterized by a malignant proliferation of CD4 + ve T cells, which may result in a degree of immunoparesis. Immunosuppression is associated with an increased incidence of internal malignant neoplasms and a high rate of nonmelanoma skin cancer, particularly squamous cell carcinoma. Therefore, we reviewed the incidence of secondary malignant neoplasms in patients with SS.Observations: Of 71 patients with SS, 16 (23%) developed 19 secondary and tertiary malignant neoplasms. These malignant neoplasms included 8 cutaneous squamous cell carcinomas, 2 squamous cell carcinomas of the oral mucosa, and 9 other internal malignant neoplasms. The incidence of internal malignant neoplasms was twice that reported in patients of similar age treated for Hodgkin disease (P = .02). Furthermore, the incidence of cutaneous squamous cell carcinoma in the cohort was 42 times that observed in a study con-ducted in England of an age-matched population (1657 per 1 ϫ 10 5 vs 39 per 1 ϫ 10 5 person-years [95% confidence interval, 626-2856]).Conclusions: A number of therapeutic modalities for SS are known to be carcinogenic. We compared the different therapeutic modalities received by our patients and found no significant difference between the total cohort of patients with SS and the patients who developed secondary malignant neoplasms. These data indicate that the high incidence of secondary malignant neoplasms in patients with SS is due, at least in part, to the disease itself. The clonal proliferation of CD4 + ve T cells and the relative lymphopenia (compared with a healthy population) of nonneoplastic T cells may result in compromised immunosurveillance, so that early neoplasia, whether arising spontaneously or as a result of therapy, are not dealt with appropriately.

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Section: P Revious Studiescontrasting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Secondary Malignant Neoplasms in 71 Patients With Sézary Syndrome

Scarisbrick

Child²,

Evans³

et al. 1999

Arch Dermatol

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“…Vor allem das spinozelluläre Karzinom tritt nach PUVA häufiger auf, nicht jedoch das Basalzellkarzinom [1,11,20,24,34,41,45]. Wichtig ist, dass eine Dosisabhängig-keit zwischen PUVA und nachfolgender Krebsentstehung besteht [1,27,41] …”

Section: Klinische Karzinogenese Nach Phototherapieunclassified

Phototherapie und Karzinogenese

Hofbauer

2013

Hautarzt

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Phototherapie ist, wie in den anderen DNS-Schäden bei PhototherapieVerschiedene Wellenlängen kommen bei der Phototherapie zum Einsatz. Am besten beschrieben sind Effekte für PUVA und UVB in ihrer Wirkung auf die DNS.UVB und "UVB narrow band" (UVBnb; synonym mit UVB-Schmalband, UVB 311 nm) unterscheiden sich um das 10-Fache in der therapeutisch angewandten Energiedosis. Klinische Karzinogenese nach PhototherapiePsoriatiker mit PUVA-Behandlung stellen die bestdokumentierte Patientengruppe mit langfristiger Nachbeobachtung dar. Vor allem das spinozelluläre Karzinom tritt nach PUVA häufiger auf, nicht jedoch das Basalzellkarzinom [1,11,20,24,34,41,45]. Wichtig ist, dass eine Dosisabhängig-keit zwischen PUVA und nachfolgender Krebsentstehung besteht [1,27,41]

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