Role of non-surgical therapies in the management of periocular basal cell carcinoma and squamous intra-epidermal carcinoma: a case series and review of the literature

TY - JOUR

T1 - Role of non-surgical therapies in the management of periocular basal cell carcinoma and squamous intra-epidermal carcinoma

T2 - a case series and review of the literature

AU - Attili, Sasi K.

AU - Ibbotson, Sally H.

AU - Fleming, Colin

N1 - © 2012 John Wiley & Sons A/S.

PY - 2012/4

Y1 - 2012/4

N2 - Background: Basal cell carcinoma (BCC) and squamous intra-epidermal carcinoma (IEC) are the most common periocular tumours and can be associated with significant morbidity. Five percent of imiquimod cream and photodynamic therapy (PDT) are popular non-surgical treatment options but are currently not licensed for periocular use.Objectives: To review our experience with these treatments and summarize published literature (PubMed: up to September 2011).Patients and Methods: We conducted a review of case notes for all patients with periocular BCC and IEC treated with either PDT or imiquimod, within National Health Service (NHS) Tayside, Scotland, from 1996 to 2009. Results: Six of 13 and five of 12 lesions treated with imiquimod (median duration of clearance = 35 months; range = 24-55 months) and PDT (median duration of clearance = 66 months; range = 4-80 months), respectively, achieved clinical clearance. The majority of patients in our series did manage to tolerate and continue both treatments, with no significant longer-term adverse effects.Conclusions: Our limited experience along with published reports suggests that both imiquimod and PDT are effective in the treatment of periocular non-melanoma skin cancers in selected patients. However, surgical excision with margin control remains the gold standard for the treatment of periocular tumours.

AB - Background: Basal cell carcinoma (BCC) and squamous intra-epidermal carcinoma (IEC) are the most common periocular tumours and can be associated with significant morbidity. Five percent of imiquimod cream and photodynamic therapy (PDT) are popular non-surgical treatment options but are currently not licensed for periocular use.Objectives: To review our experience with these treatments and summarize published literature (PubMed: up to September 2011).Patients and Methods: We conducted a review of case notes for all patients with periocular BCC and IEC treated with either PDT or imiquimod, within National Health Service (NHS) Tayside, Scotland, from 1996 to 2009. Results: Six of 13 and five of 12 lesions treated with imiquimod (median duration of clearance = 35 months; range = 24-55 months) and PDT (median duration of clearance = 66 months; range = 4-80 months), respectively, achieved clinical clearance. The majority of patients in our series did manage to tolerate and continue both treatments, with no significant longer-term adverse effects.Conclusions: Our limited experience along with published reports suggests that both imiquimod and PDT are effective in the treatment of periocular non-melanoma skin cancers in selected patients. However, surgical excision with margin control remains the gold standard for the treatment of periocular tumours.

KW - Eye

KW - Antineoplastic Agents

KW - Humans

KW - Photochemotherapy

KW - Aged

KW - Carcinoma, Basal Cell

KW - Skin Neoplasms

KW - Aminoquinolines

KW - Aged, 80 and over

KW - Middle Aged

KW - Carcinoma, Squamous Cell

KW - Administration, Topical

KW - Female

KW - Male

U2 - 10.1111/j.1600-0781.2011.00640.x

DO - 10.1111/j.1600-0781.2011.00640.x

M3 - Article

C2 - 22409709

SN - 0905-4383

VL - 28

SP - 68

EP - 79

JO - Photodermatology, Photoimmunology & Photomedicine

JF - Photodermatology, Photoimmunology & Photomedicine

IS - 2

ER -