Treatment of Basal Cell Carcinoma
Treatment of Basal Cell Carcinoma
Objective: Intralesional injections of interferon have been reported to provide successful results in the treatment of basal cell carcinoma. However, there are only a few reports describing the long-term efficacy of this therapy. The aim of our study was to evaluate the efficacy and long-term results of interferon a-2a (IFNa-2a) in the treatment of basal cell carcinoma.
Methods: Twenty dermatopathologically proven basal cell carcinoma lesions were treated with intralesional IFNa-2a injections three times weekly for 3 weeks. The dose per injection was 1.5 x 10 IU if the lesion was ≥2cm in diameter and 3.0 x 10 IU if it was =2cm. Eight weeks after the last injection, the lesion sites were rebiopsied and all cases were reevaluated both clinically and dermatopathologically. Patients with complete cure were followed up for 7 years to determine the long-term results.
Results: Eleven lesions (55%) showed complete clinical and dermatopathological remission, six lesions (30%) showed partial remission, and two lesions (10%) showed no response. One lesion (5%) increased in size during the treatment. No serious adverse effects were observed. During the follow-up period there was only one recurrence, at the fifth year.
Conclusion: Treatment with intralesional IFNa-2a was shown to be an effective therapeutic option for basal cell carcinoma, with low recurrence rates in long-term follow-up.
Basal cell carcinoma (BCC) is the most common cutaneous tumour in humans. The lesions are most frequently found on sun-exposed areas and especially on the face. There are several treatment modalities for BCC such as excisional surgery, Mohs' surgery, electrodesiccation and curettage, cryotherapy and radiotherapy. Mohs' surgery is the most successful option, with a cure rate of 99%. The other methods have also been found to be highly effective, especially for small and noninvasive BCCs, with cure rates ranging between 89% and 97%.
All of these classical techniques have scarring potential and cosmetic results may be unsatisfactory, particularly for facial lesions. Moreover, surgery cannot be easily performed in elderly patients with serious systemic problems. All of these difficulties have meant there is a need for an effective, non-surgical method that has good cosmetic results.
Interferons are a large protein/glycoprotein family that have antiviral, antiproliferative and anti- tumoral activities. In 1986, Greenway et al. reported a 100% cure rate in the treatment of BCC with intralesional interferon a-2a (IFNa-2a), and this impressive result initiated many clinical studies on this subject. Over the past few years, many reports have been published with variable success rates, but in most of these studies follow-up periods were not sufficiently long (≥5 years) to evaluate the exact efficacy of the therapy.
We report here our experiences and long-term results in 13 patients with a total of 20 BCCs treated with IFNa-2a and followed up for 7 years.
Objective: Intralesional injections of interferon have been reported to provide successful results in the treatment of basal cell carcinoma. However, there are only a few reports describing the long-term efficacy of this therapy. The aim of our study was to evaluate the efficacy and long-term results of interferon a-2a (IFNa-2a) in the treatment of basal cell carcinoma.
Methods: Twenty dermatopathologically proven basal cell carcinoma lesions were treated with intralesional IFNa-2a injections three times weekly for 3 weeks. The dose per injection was 1.5 x 10 IU if the lesion was ≥2cm in diameter and 3.0 x 10 IU if it was =2cm. Eight weeks after the last injection, the lesion sites were rebiopsied and all cases were reevaluated both clinically and dermatopathologically. Patients with complete cure were followed up for 7 years to determine the long-term results.
Results: Eleven lesions (55%) showed complete clinical and dermatopathological remission, six lesions (30%) showed partial remission, and two lesions (10%) showed no response. One lesion (5%) increased in size during the treatment. No serious adverse effects were observed. During the follow-up period there was only one recurrence, at the fifth year.
Conclusion: Treatment with intralesional IFNa-2a was shown to be an effective therapeutic option for basal cell carcinoma, with low recurrence rates in long-term follow-up.
Basal cell carcinoma (BCC) is the most common cutaneous tumour in humans. The lesions are most frequently found on sun-exposed areas and especially on the face. There are several treatment modalities for BCC such as excisional surgery, Mohs' surgery, electrodesiccation and curettage, cryotherapy and radiotherapy. Mohs' surgery is the most successful option, with a cure rate of 99%. The other methods have also been found to be highly effective, especially for small and noninvasive BCCs, with cure rates ranging between 89% and 97%.
All of these classical techniques have scarring potential and cosmetic results may be unsatisfactory, particularly for facial lesions. Moreover, surgery cannot be easily performed in elderly patients with serious systemic problems. All of these difficulties have meant there is a need for an effective, non-surgical method that has good cosmetic results.
Interferons are a large protein/glycoprotein family that have antiviral, antiproliferative and anti- tumoral activities. In 1986, Greenway et al. reported a 100% cure rate in the treatment of BCC with intralesional interferon a-2a (IFNa-2a), and this impressive result initiated many clinical studies on this subject. Over the past few years, many reports have been published with variable success rates, but in most of these studies follow-up periods were not sufficiently long (≥5 years) to evaluate the exact efficacy of the therapy.
We report here our experiences and long-term results in 13 patients with a total of 20 BCCs treated with IFNa-2a and followed up for 7 years.
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