PMID- 34865224
OWN - NLM
STAT- MEDLINE
DCOM- 20220127
LR  - 20220127
IS  - 1096-9101 (Electronic)
IS  - 0196-8092 (Linking)
VI  - 54
IP  - 1
DP  - 2022 Jan
TI  - Efficacy and safety of laser-assisted combination chemotherapy: A follow-up study 
      of treatment with 5-fluorouracil and cisplatin for basal cell carcinoma.
PG  - 113-120
LID - 10.1002/lsm.23497 [doi]
AB  - BACKGROUND AND OBJECTIVES: There is a growing need for effective topical 
      treatments for basal cell carcinoma (BCC). By altering the skin barrier, ablative 
      fractional lasers (AFLs) enhance cutaneous uptake of the synergistic 
      chemotherapeutic agents, cisplatin, and 5-fluorouracil (5-FU). In our recently 
      reported clinical trial, AFL-assisted delivery of cisplatin and 5-FU showed 
      favorable short-term clearance rates of 95% with good cosmetic results at 3 
      months. This follow-up study assessed sustained tumor clearance, safety, and 
      cosmesis in the same patient cohort, observed 6- and 12-months posttreatment. 
      MATERIALS AND METHODS: This follow-up study assessed AFL-assisted cisplatin and 
      5-FU in low-risk BCC. Among the 18/19 patients who achieved clinical tumor 
      clearance in our 3-months primary trial, all were included for a 6-months 
      follow-up. At 12 months, 17/19 were included due to one 6-month residual. During 
      follow-up visits, treated areas were evaluated for signs of recurrent tumour by 
      clinical inspection and optical coherence tomography (OCT). Residual tumors were 
      confirmed histologically. Cosmetic outcome was evaluated at both follow-up visits 
      by patients and physicians. RESULTS: Overall, complete tumor clearance was 89% 
      (17/19) and 79% (15/19) at 6 and 12 months, respectively. Clearance rate for 
      superficial BCCs (sBCCs) 1 year after treatment was 100% (6/6) and lower for 
      nodular BCC (nBCC) at 69% (9/13). Among recurrent tumors, 67% (2/3) had received 
      only a single treatment and all were of the nodular subtype, situated in the head 
      and neck area. All histologically confirmed BCC recurrences were identified by 
      OCT. Cosmetic outcomes were similarly rated "good" or "excellent" by patients and 
      evaluators (p = 0.289 and p = 0.250). Treatment-related local skin reactions were 
      mild and tolerable, consisting of persisting erythema in two patients at the end 
      of the study. Dyspigmentation was commonly observed at both follow-up visits, 
      while the appearance of scarring resolved in the majority of patients between 6 
      months (56%; 10/18) and 12 months (76%; 13/17). CONCLUSION: AFL-assisted 
      cisplatin + 5-FU in double sessions represents an acceptable and safe treatment 
      strategy for low-risk sBCC, while clearance rates following single treatment or 
      for nBCC seem inferior. This intensified topical strategy may be best suited to 
      cases of multiple lesions or in instances where surgical excision or extended 
      courses of at-home therapy is challenging.
CI  - (c) 2021 Wiley Periodicals LLC.
FAU - Fredman, Gabriella
AU  - Fredman G
AUID- ORCID: 0000-0003-3903-2651
AD  - Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, 
      Copenhagen, Denmark.
FAU - Wenande, Emily
AU  - Wenande E
AD  - Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, 
      Copenhagen, Denmark.
FAU - Hendel, Kristoffer
AU  - Hendel K
AD  - Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, 
      Copenhagen, Denmark.
FAU - Togsverd-Bo, Katrine
AU  - Togsverd-Bo K
AD  - Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, 
      Copenhagen, Denmark.
FAU - Haedersdal, Merete
AU  - Haedersdal M
AD  - Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, 
      Copenhagen, Denmark.
LA  - eng
PT  - Case Reports
PT  - Research Support, Non-U.S. Gov't
DEP - 20211205
PL  - United States
TA  - Lasers Surg Med
JT  - Lasers in surgery and medicine
JID - 8007168
RN  - Q20Q21Q62J (Cisplatin)
RN  - U3P01618RT (Fluorouracil)
SB  - IM
MH  - *Carcinoma, Basal Cell/drug therapy
MH  - Cisplatin/therapeutic use
MH  - Fluorouracil/therapeutic use
MH  - Follow-Up Studies
MH  - Humans
MH  - Lasers
MH  - *Photochemotherapy
MH  - *Skin Neoplasms/drug therapy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - 5-Fluourouracil
OT  - ablative fractional CO2 laser
OT  - cisplatin
OT  - laser-assisted drug delivery
OT  - optical coherence tomography
OT  - skin cancer
OT  - topical chemotherapy
OT  - topical drug delivery
EDAT- 2021/12/06 06:00
MHDA- 2022/01/28 06:00
CRDT- 2021/12/05 21:52
PHST- 2021/11/10 00:00 [revised]
PHST- 2021/09/02 00:00 [received]
PHST- 2021/11/12 00:00 [accepted]
PHST- 2021/12/06 06:00 [pubmed]
PHST- 2022/01/28 06:00 [medline]
PHST- 2021/12/05 21:52 [entrez]
AID - 10.1002/lsm.23497 [doi]
PST - ppublish
SO  - Lasers Surg Med. 2022 Jan;54(1):113-120. doi: 10.1002/lsm.23497. Epub 2021 Dec 5.