Tratamientos tópicos también son efectivos en carcinoma basocelular.

Topical Skin Creams Effective to Treat Superficial Basal Cell Carcinoma

June 2, 2016

PHILADELPHIA -- June 2, 2016 -- A 3-year randomised controlled clinical trial has found that 2 topical creams are effective for most patients with primary, low-risk superficial basal cell carcinoma (BCC), comparing favourably with photodynamic therapy (PDT), according to a study published in the Journal of Investigative Dermatology.

Topical treatments are available for superficial BCC, but there has been a lack of long-term follow-up data to guide treatment decisions. While most types of BCC require surgery, superficial BCC can be treated topically with noninvasive treatments such as PDT, imiquimod cream, fluorouracil cream, cryosurgery or electrodessication and curettage.

The current study compared 3 noninvasive treatments that included imiquimod and fluorouracil cream.

"The main advantages of noninvasive treatments are good cosmetic outcome, preservation of surrounding tissue, and potential for home application of either creams," said lead investigator Marieke Roozeboom, MD, Department of Dermatology, Maastricht University Medical Center, Maastricht, the Netherlands. "Throughout the last 2 decades there has been a growing interest in these non-surgical therapies, which offer the possibility of avoiding surgery and reducing demands on busy medical practices."

A total of 601 patients with a superficial BCC participated in the study. Of the patients, 202 were treated with methylaminolevulinate photodynamic therapy (MAL-PDT), 198 with imiquimod cream, and 201 with fluorouracil cream. The 3 study groups had a similar distribution of baseline characteristics, with the exception of tumour size.

Around 80% of patients with superficial BCC were tumour-free after imiquimod treatment after 3 years. The clearance rate was 68% for patients treated with fluorouracil and 58% for individuals receiving PDT.

"Based on our findings, both imiquimod and fluorouracil are effective noninvasive treatments in most primary, low-risk superficial BCC, but the data provide no definite evidence for superiority of imiquimod to fluorouracil," said Dr. Roozeboom. "Both creams have an equal cosmetic outcome and risk of local adverse events. Fluorouracil has the advantage of being less expensive than imiquimod. However, between 1- and 3-year follow-up, more recurrences were diagnosed in the fluorouracil group compared with the imiquimod group."

"When choosing a treatment for an individual patient with a superficial BCC, other factors like age, compliance, and patient preferences should always be taken into account," he added. "For example, we have found that in superficial BCC on the lower extremities in older patients, PDT should be prescribed rather than imiquimod. Our evidence indicates that a personalized treatment approach is necessary."

SOURCE: Elsevier