Medical Sciences Asked by Franck Dernoncourt on December 14, 2020
I wonder how effective topical fluorouracil is to treat facial superficial basal cell carcinoma (BCC).
What I have found so far doesn’t give any source supporting their claims or I cannot access them:
https://bpac.org.nz/2017/skin-cancer.aspx:
Apply twice daily, for six to 12 weeks; N.B. Fluorouracil is generally only used to treat small, very superficial BCC, and treatment is associated with a high rate of recurrence
https://www.drugs.com/monograph/fluorouracil-topical.html#ra:
Used topically for the treatment of superficial basal cell carcinoma when conventional methods are impractical (e.g., in patients with multiple lesions or difficult treatment sites).a b g Efficacy not established for treatment of other basal cell carcinomas; establish diagnosis before initiating treatment. [references a b g]
When lesions are isolated and easily accessible, conventional techniques (e.g., surgery, curettage and dessication, cryotherapy) are preferred because they have a higher response rate. [references a b g]
(I don’t have access to references a b g)
{1,2} focus on actinic keratoses, e.g. from {2}:
The results of this meta-analysis show that both imiquimod and 5-fluorouracil are effective methods for the treatment of actinic keratosis and provide a useful alternative to cryotherapy. However, this analysis suggests that imiquimod may have higher efficacy than 5-fluorouracil for actinic keratosis lesions located on the face and scalp and therefore provides another option to dermatologists.
References:
The 2009 systematic review {1} summarized the success rate of the use of topical fluorouracil cream to treat a superficial basal cell carcinoma (BCC). It found only 1 study, which reported a 90% success rate (at 3-week follow-up, so an important remaining question is what the success rate is after a few years). See the first row of this table (Gross et al.) from {1}:
References:
Answered by Franck Dernoncourt on December 14, 2020
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