Treatments for Basal Cell and Squamous Cell Carcinoma of the Skin

Abstract

Key MessagesPurpose of Review Assess comparative effectiveness and safety of treatments for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Key Messages• Comparative evidence on treatment of BCC and SCC is limited. Many comparisons were evaluated in one or two randomized controlled trials only.• Surgery and radiotherapy have lower recurrence rates for BCC than interventions that destroy lesions with heat or cold, photodynamic therapy (PDT), or curettage.• There is moderate confidence that PDT for BCC is associated with better cosmetic outcomes than surgery.• Serious adverse events, events leading to treatment discontinuation, and treatment site infections were uncommon with all treatments for BCC.• Recurrence rates for SCC in situ were lower with PDT and cryotherapy than with drugs.Evidence was insufficient to draw conclusions for other treatments.ii This report is based on research conducted by the Brown Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2015-00002-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.The information in this report is intended to help health care decisionmakers-patients and clinicians, health system leaders, and policymakers, among others-make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.This report is made available to the public under the terms of a licensing agreement between the author and the Agency for Healthcare Research and Quality. This report may be used and reprinted without permission except those copyrighted materials that are clearly noted in the report. Further reproduction of those copyrighted materials is prohibited without the express permission of copyright holders.AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies, may not be stated or implied. This report may periodically be assessed for the currency of conclusions. If an assessment is done, the resulting surveillance report describing the methodology and findings will be found on the Effective Health Ca...

Photodynamic Therapy for Basal Cell Carcinoma: The Clinical Context for Future Research Priorities

“…Surgical excision is often regarded as the standard treatment for high-risk BCC and is also used in the treatment of low-risk BCC, as it offers the lowest recurrence rates [ 97 , 139 , 140 ]. However, PDT and other noninvasive treatments are also appropriate for low-risk BCC of superficial depth, with a particular advantage for multiple and large surface area lesions or poorly healing skin sites, and a cosmetic outcome is demonstrably superior with PDT [ 91 , 92 , 93 ] A recent systematic review and network meta-analysis indicated that, while there was a clear advantage of lower recurrence rates of surgery over PDT, there was a moderate strength conclusion that PDT was associated with significantly better cosmetic outcomes than surgery [ 141 , 142 ].…”

Photodynamic therapy for skin carcinomas: A systematic review and meta-analysis

“…Although the current treatments are effective to varying degrees, they tend to lack specificity and often do not target the tumor itself or the environment in which it exists ( 6 ). They are also associated with a high incidence of adverse effects and yield undesirable cosmetic results ( 7 , 8 ). As such, alternative treatments options for patients with these conditions are needed.…”

Possibilities of radiation therapy for skin cancer in long-lived patients (over 90 years old)

“…В доступной литературе широко обсуждаются проблемы лечения пациентов пожилого и старческого возраста со злокачественными новообразованиями кожи [1]. Это связано с трудностями использования специальных методов терапии, которые могут негативно отразиться на качестве жизни больных [2][3][4][5]. Решение о проведении противоопухолевой терапии у долгожителей (лиц старше 90 лет) требует большого профессионализма от клиницистов.…”