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Buján Bonino C, Rodríguez-Blanco I, Sánchez-Aguilar Rojas D, Vázquez Veiga HA, Flórez Á. Topical and Intralesional Immunotherapy for the Management of Skin Cancer in Special Locations: Lips and Eyelids. Cancers (Basel) 2023; 15:5018. [PMID: 37894385 PMCID: PMC10604909 DOI: 10.3390/cancers15205018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
The use of topical and intralesional immunotherapy in the treatment of cutaneous malignant neoplasia in sensitive areas such as the lips and eyelids is discussed. Surgery may not be feasible or may result in deformities in these areas, making alternative treatment options necessary. A narrative literature review was conducted using MEDLINE (PubMed) as the main literature database, collecting available evidence of experiences with various topical and intralesional therapies in the aforementioned anatomical locations, ranging from case reports to clinical trials. The clearance rates and potential adverse reactions of therapeutic options such as imiquimod 5%, 5-fluorouracil (5-FU), photodynamic therapy (PDT), ingenol mebutate (IM), diclofenac, intralesional methotrexate, and interferon are reviewed. Although limited by their heterogeneity and the scarcity of clinical trials, these studies point towards promising response rates and minimal adverse effects, making these treatments viable options in selected cases.
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Affiliation(s)
- Cecilia Buján Bonino
- Department of Dermatology, University Hospital of Santiago de Compostela, 36001 Santiago de Compostela, Spain
| | - Isabel Rodríguez-Blanco
- Department of Dermatology, University Hospital of Santiago de Compostela, 36001 Santiago de Compostela, Spain
| | | | - Hugo A. Vázquez Veiga
- Department of Dermatology, University Hospital of Santiago de Compostela, 36001 Santiago de Compostela, Spain
| | - Ángeles Flórez
- Department of Dermatology, University Hospital of Pontevedra, 36162 Pontevedra, Spain
- DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Servizo Galego de Saúde—Universidade de Vigo (SERGAS—UVIGO), 36213 Vigo, Spain
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Wladis EJ, Wrzesinski SH, Rothschild MI, Adam AP. Emerging therapeutic options for periorbital and orbital cutaneous basal and squamous cell carcinomas. Orbit 2023; 42:117-123. [PMID: 36214105 DOI: 10.1080/01676830.2022.2130363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE Recently, several new therapies have emerged to address locally advanced cutaneous basal cell and squamous cell carcinomas. Given the constraints of the ocular adnexa and orbit, this review was designed to discuss the role of these modalities in this region. METHODS A PubMed search was carried out to analyze the utility of United States Food and Drug Administration-approved therapies to address these malignancies. The data presented in the identified investigations were analyzed and abstracted. RESULTS Multiple novel interventions may be useful in the management of periocular cutaneous basal cell and squamous cell carcinomas, including imiquimod, hedgehog inhibitors, and immunotherapy. While many of these treatments have not been specifically explored in the orbit and ocular adnexa, the literature generally shows favorable response rates. However, adverse events were common in these studies. CONCLUSIONS Several novel treatments may address periorbital cutaneous malignancies, and these therapies may be particularly useful in patients with unresectable disease and those who are poor surgical candidates.
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Affiliation(s)
- Edward J Wladis
- Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Albany, New York, USA.,Department of Otolaryngology, Albany Medical College, Albany, New York, USA
| | - Stephen H Wrzesinski
- Division of Oncology, Department of Medicine, Albany Medical College, Albany, New York, USA
| | - Michael I Rothschild
- Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Albany, New York, USA
| | - Alejandro P Adam
- Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Albany, New York, USA.,Center for Molecular Physiology, Albany Medical College, Albany, New York, USA
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Neumann I, Patalay R, Kaushik M, Timlin H, Daniel C. Treatment of periocular lentigo maligna with topical 5% Imiquimod: a review. Eye (Lond) 2023; 37:408-414. [PMID: 35835989 PMCID: PMC9905524 DOI: 10.1038/s41433-022-02165-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/13/2022] [Accepted: 06/20/2022] [Indexed: 11/08/2022] Open
Abstract
Lentigo Maligna is a benign subtype of melanoma in situ and can progress to lentigo maligna melanoma, which is invasive. Complete surgical excision is the gold standard of treatment but requires large margins. If affecting the peri-ocular region, surgical excision leads to extensive defects, complex reconstructions, and functional impairment of the protection of the ocular surface. Here we review the reported literature about the use of Imiquimod 5% topical cream for lentigo maligna of the eyelid, the treatment outcomes, side effects and tolerance. In addition, the side effects of imiquimod treatment of non-LM lesions are described to help better inform the decision-making process. Treatment for peri-ocular Lentigo maligna showed a 56-86% complete treatment response and a 90% tolerability rate. However, reported treatment protocols vary and histopathological confirmation of clearance was only obtained in 56%. Further studies are required to determine the optimal treatment protocol to maximise clearance rates. Overall, Imiquimod was well tolerated in the peri-ocular area.
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Affiliation(s)
- Inga Neumann
- Adnexal Department, Moorfields Eye Hospital, London, UK.
| | - R Patalay
- Dermatology Department, Guys and St. Thomas Hospital, London, UK
| | - M Kaushik
- Adnexal Department, Moorfields Eye Hospital, London, UK
| | - H Timlin
- Adnexal Department, Moorfields Eye Hospital, London, UK
| | - C Daniel
- Adnexal Department, Moorfields Eye Hospital, London, UK
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Singh M, Mehta Grewal A, Singh H, Sharma M, Kaur M, Gupta P, Zadeng Z. Long-term efficacy and safety of imiquimod 5% and fluorouracil 1% creams in medical monotherapy of complex eyelid basal cell carcinomas. Eur J Ophthalmol 2021; 32:2093-2100. [PMID: 34320864 DOI: 10.1177/11206721211035614] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To study the long-term efficacy and safety of local application of imiquimod 5% and fluorouracil 1% creams in complex eyelid basal cell carcinomas (BCCs). METHODS A retrospective, non-comparative study in biopsy-proven, complex (involving canthi or >50% of eyelid length) eyelid BCC patients who were medically unfit for surgical procedures. All patients were medically treated with either of the creams using fixed-dose regimens for a minimum of 3 months. All received oral vitamin C 500 mg QID for 3 months as an adjunct for collagen healing. A minimum of "post-treatment" follow-up of 12 months was observed. RESULTS Of total 30 patients, imiquimod 5% and fluorouracil 1% were used in 16 and 14 patients, respectively. The mean age of our patients was 70.5 years. The co-morbidities included - severe coronary artery disease using blood-thinners (n = 19), poorly controlled diabetes (n = 12), poorly controlled hypertension (n = 6), on nebulization (n = 3), and tuberculosis with pulmonary fibrosis (n = 2). Complete clinical tumor resolution was noted in 10 and 8 patients over 12 and 16.5 weeks, respectively, in imiquimod and fluorouracil groups. Periocular skin erythema, chemical conjunctivitis, and skin depigmentation were seen in all the patients of imiquimod group. On the other hand, the local side-effect profile in fluorouracil patients was limited. CONCLUSION The medical treatment of complex eyelid BCC is a useful alternative to surgery in the elderly with significant co-morbidities. It provides a promising long-term relief with a tolerable side-effect profile. A prospective, randomized, double-blinded trial would provide stronger evidence for the efficacy of these drugs.
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Affiliation(s)
- Manpreet Singh
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aditi Mehta Grewal
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Himanshi Singh
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manjula Sharma
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manpreet Kaur
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Gupta
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Zoramthara Zadeng
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Kash N, Silapunt S. A review of emerging and non-US FDA-approved topical agents for the treatment of basal cell carcinoma. Future Oncol 2021; 17:3111-3132. [PMID: 34156307 DOI: 10.2217/fon-2020-1147] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Although surgical therapy continues to be the gold standard for the treatment of basal cell carcinoma given high cure rates and the ability to histologically confirm tumor clearance, there are a number of nonsurgical treatment options that may be considered based on individual tumor characteristics, functional and cosmetic considerations, patient comorbidities and patient preference. Topical 5-fluorouracil 5% cream and imiquimod 5% cream have been US FDA-approved for the treatment of superficial basal cell carcinoma. Additionally, a number of new and emerging topical agents and techniques have been described for the treatment of basal cell carcinoma and will be reviewed herein.
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Affiliation(s)
- Natalie Kash
- Department of Dermatology, Kansas City University-Graduate Medical Education Consortium/Advanced Dermatology & Cosmetic Surgery Orlando Program, Maitland, FL 32751, USA
| | - Sirunya Silapunt
- Department of Dermatology, University of Texas McGovern Medical School at Houston, Houston, TX 77030, USA
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Moon J, Choi SH, Lee MJ, Jo DH, Park UC, Yoon SO, Woo SJ, Oh JY. Ocular surface complications of local anticancer drugs for treatment of ocular tumors. Ocul Surf 2020; 19:16-30. [PMID: 33238207 DOI: 10.1016/j.jtos.2020.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/12/2020] [Accepted: 11/16/2020] [Indexed: 02/03/2023]
Abstract
Local chemotherapy is increasingly used, either in combination with surgery or as monotherapy, for management of ocular tumors. Yet many of the local chemotherapeutic agents used for ocular tumors are cytotoxic drugs that are frequently associated with toxicities in normal ocular tissues. Understanding and managing these side effects are important because they affect treatment tolerability, outcome and quality of vision. Herein, we review local anticancer drugs administered for the treatment of ocular tumors, with an emphasis on their toxicities to the ocular surface, adnexa and lacrimal drainage system. We provide the underlying mechanisms and management strategies for the ocular side effects. Recent innovations in anticancer immunotherapy and ocular drug delivery systems also are discussed as new potential therapeutic modalities for alleviation of side effects.
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Affiliation(s)
- Jayoon Moon
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea; Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Se Hyun Choi
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, 22, Gwanpyeong-ro 170 Beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, South Korea
| | - Min Joung Lee
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, 22, Gwanpyeong-ro 170 Beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, South Korea
| | - Dong Hyun Jo
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Un Chul Park
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Sun-Ok Yoon
- R & D Lab, Eutilex Co., Ltd, Gasan Digital 1-ro 25, Geumcheon-gu, Seoul, 08594, South Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea; Department of Ophthalmology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea
| | - Joo Youn Oh
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea; Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
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Huang CM, Kirchhof MG. Topical Imiquimod as a Treatment Option for Nodular Basal Cell Carcinoma: A Systematic Review. J Cutan Med Surg 2020; 24:495-503. [PMID: 32527151 DOI: 10.1177/1203475420931770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Surgical excision is considered standard treatment for nodular basal cell carcinoma (nBCC). However, patients who reject or are unsuited for surgery may benefit from imiquimod (IMQ) 5% cream as an alternative treatment. OBJECTIVES The objective of this study was to conduct a systematic review on the efficacy and safety of IMQ for the treatment of nBCC. MATERIALS AND METHODS The terms basal cell carcinoma AND imiquimod OR Aldara were searched on Ovid-MEDLINE, EMBASE, and Cochrane Library databases. Articles were included if they reported the efficacy or side effects of IMQ for nBCC. Primary outcomes included clearance (clinical and histological), recurrence rates, and adverse events. Number of lesions/subjects, treatment regimens, length of treatment, and time to recurrence were secondary outcomes. RESULTS Thirty-nine publications, totaling 738 lesions, revealed a 77.4% (335/433 lesions) clinical and 72.9% (390/535 lesions) histological clearance rate. Regimens ranged from once daily 2 days a week to twice daily 7 days a week. Average treatment duration was 8.81 (±3.49) weeks. There was a 1.80% recurrence rate after an average follow-up period of 13.03 (±15.09) months. Common adverse effects included erythema (77.2%), crusting (50.5%), pruritus (34.1%), tenderness/irritation (27.3%), ulceration (25.4%), burning (22.1%), and erosion (21.7%). Unforeseen side effects included conjunctivitis, keratitis, depigmentation, comedone formation, and ruptured epidermoid cysts. CONCLUSION Imiquimod showed clinical and histological clearance rates of over 70% for nBCC, with a recurrence rate of 1.80%. Although clearance rates are lower than surgery, IMQ can be considered as a treatment option for nBCC in those who decline or are unfit for surgical intervention.
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Affiliation(s)
- Christina M Huang
- 12365 Division of Dermatology, Department of Medicine, University of Ottawa and The Ottawa Hospital, ON, Canada
| | - Mark G Kirchhof
- 12365 Division of Dermatology, Department of Medicine, University of Ottawa and The Ottawa Hospital, ON, Canada
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8
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Treatment of squamous cell carcinoma of the eyelid with imiquimod 5% cream. Can J Ophthalmol 2019; 54:e24-e27. [DOI: 10.1016/j.jcjo.2018.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 03/20/2018] [Accepted: 03/27/2018] [Indexed: 11/22/2022]
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9
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Karabulut GO, Kaynak P, Ozturker C, Fazil K, Ocak OB, Taskapılı M. Imiquimod 5% cream for the treatment of large nodular basal cell carcinoma at the medial canthal area. Indian J Ophthalmol 2017; 65:48-51. [PMID: 28300740 PMCID: PMC5369293 DOI: 10.4103/ijo.ijo_958_16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Context (Background): Imiquimod (IMQ) 5% cream is an immunomodulatory and antitumorigenic agent, which was used as a topical treatment regimen, who had periocular basal cell carcinoma (BCC). Aim: This study aims to present three cases with large BCC at the medial canthal area treated with IMQ 5% cream. Materials and Methods: IMQ 5% cream was used in three patients with ages 45, 49, and 73 who preferred medical treatment over surgery. Following incisional biopsy IMQ cream was used once a day, 5 times a week and the patients were followed up weekly during 12 week treatment period and monthly after the clearance of the lesion. Results: Erythema and erosion on the surface of the lesion, injection of conjunctiva, burning and itching sensation, epiphora and punctate keratitis were seen in all patients during the treatment period. The ophthalmic side effects could be managed by topical lubricating eye drops and the inflammatory reactions resolved within 1 month after cessation of therapy. The patients were followed up for at least 3 years without tumor recurrence and the biopsies taken from the suspected area were found to be tumor free. Conclusion: Surgical excision of carcinoma of the eyelid at medial canthal area can be difficult without causing damage to the lacrimal system and reconstruction of the defect may need grafts or flaps. IMQ may provide an alternative therapy to surgery in certain cases.
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Affiliation(s)
- Gamze Ozturk Karabulut
- Department of Ophthalmic and Plastic Surgery, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421 Istanbul, Turkey
| | - Pelin Kaynak
- Department of Ophthalmic and Plastic Surgery, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421 Istanbul, Turkey
| | - Can Ozturker
- Department of Ophthalmic and Plastic Surgery, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421 Istanbul, Turkey
| | - Korhan Fazil
- Department of Ophthalmic and Plastic Surgery, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421 Istanbul, Turkey
| | - Osman Bulut Ocak
- Department of Ophthalmology, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421 Istanbul, Turkey
| | - Muhittin Taskapılı
- Department of Ophthalmology, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421 Istanbul, Turkey
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Shi Y, Jia R, Fan X. Ocular basal cell carcinoma: a brief literature review of clinical diagnosis and treatment. Onco Targets Ther 2017; 10:2483-2489. [PMID: 28507440 PMCID: PMC5428761 DOI: 10.2147/ott.s130371] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Basal cell carcinoma (BCC) is a common malignant tumor throughout the world. One of the known risk factors of BCC is intense exposure to ultraviolet radiation. More than 50% of BCCs of the eyelid initially occur on the lower lid. The gold standard of diagnosis of BCC is histopathology. Treatment options for BCC consist of surgery, vismodegib, radiotherapy and imiquimod. Surgical excision using Mohs micrographic surgery or wide surgical excision with frozen section margin control is the first consideration for treatment of periocular BCC. Eyelid reconstruction should be carefully considered as both function and esthetic outcome in patients are important after clear excision of tumors. Exenteration is considered in the case of extensive orbital invasion or high-risk aggressive tumors in order to reduce the rate of recurrence.
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Affiliation(s)
- Yingyun Shi
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai, People's Republic of China
| | - Renbing Jia
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai, People's Republic of China
| | - Xianqun Fan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai, People's Republic of China
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de Macedo EMS, Carneiro RC, de Lima PP, Silva BG, Matayoshi S. Imiquimod cream efficacy in the treatment of periocular nodular basal cell carcinoma: a non-randomized trial. BMC Ophthalmol 2015; 15:35. [PMID: 25885553 PMCID: PMC4450997 DOI: 10.1186/s12886-015-0024-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 03/24/2015] [Indexed: 12/20/2022] Open
Abstract
Background The recurrence rate of periocular nodular basal cell carcinoma (PNBCC) following treatment with imiquimod (IMQ) has not yet been established. Previous studies did not include histological follow-up. The aim of this analysis was to evaluate the efficacy of topical immunotherapy with 5% IMQ cream for the treatment of PNBCC. Methods Study design: A prospective, non-randomized, and uncontrolled longitudinal case series study. No participants were blinded. Punch biopsy confirmed PNBCC patients were included at the Ophthalmology Clinic of São Paulo University Medicine School Hospital (from 2008 to 2012). Patients were treated with 5% IMQ cream once a day, 5 days per week, for 8–16 weeks. Standard lesion photographic documentation was done during the study. Three months after treatment ended, an image-guided biopsy was performed. Patients were followed at 6-month intervals and annually for control biopsies. Main outcome measures were clinical and histological clearance rates. Data were analysed by frequency distribution for qualitative group characteristics and central tendency measures for quantitative data. Results Twenty-four patients met the inclusion criteria, 19 of whom remained until the end of treatment. The histological clearance rate was 89.5% and 84.2%, respectively, at 3 and 39.5 months. The 3-year histological clearance rate was 81.8% (9/11) for lesions >10 mm, and 100% (8/8) for lesions <10 mm. Three patients did not tolerate the side effects of the medication and left the study. Two patients were excluded for treatment interruption related to comorbidities. Conclusions Our results indicated that 5% IMQ cream was a useful alternative treatment for NBBCC, especially for lesions <10 mm. IMQ also showed a significant neoadjuvant effect on lesions >10 mm. Trial registration ClinicalTrial.gov Registration Dec 3, 2008: #NCT 00803907.
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Affiliation(s)
- Erick Marcet Santiago de Macedo
- Departments of Ophthalmology and Pathology, University of São Paulo School of Medicine, Av. Dr. Arnaldo, 455, São Paulo, Brazil.
| | - Rachel Camargo Carneiro
- Departments of Ophthalmology and Pathology, University of São Paulo School of Medicine, Av. Dr. Arnaldo, 455, São Paulo, Brazil.
| | | | - Breno Gonçalves Silva
- Departments of Ophthalmology and Pathology, University of São Paulo School of Medicine, Av. Dr. Arnaldo, 455, São Paulo, Brazil.
| | - Suzana Matayoshi
- Departments of Ophthalmology and Pathology, University of São Paulo School of Medicine, Av. Dr. Arnaldo, 455, São Paulo, Brazil.
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Yin VT, Merritt HA, Sniegowski M, Esmaeli B. Eyelid and ocular surface carcinoma: Diagnosis and management. Clin Dermatol 2015; 33:159-69. [DOI: 10.1016/j.clindermatol.2014.10.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Kim DD, Tang JY, Ioannidis JPA. Network geometry shows evidence sequestration for medical vs. surgical practices: treatments for basal cell carcinoma. J Clin Epidemiol 2014; 67:391-400. [PMID: 24491794 DOI: 10.1016/j.jclinepi.2013.10.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 09/29/2013] [Accepted: 10/07/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Basal cell carcinoma (BCC) is the most common cancer with 2 million treatments per year with little evidence-based guidelines for treatment. There are three classes of interventions (surgical, destructive, and topical) for BCC, and this study aimed to determine whether there are preferences or avoidances in comparisons of different types of treatments for BCC in randomized controlled trials (RCTs). STUDY DESIGN AND SETTING PubMed, Cochrane Central Registry of Clinical Trials, and ClinicalTrials.Gov were used to identify eligible published and registered ongoing RCTs. RESULTS Fifty-five trials (42 published and 13 registered trials) were identified. Only one unpublished registered trial compared a topical vs. a surgical intervention, and only one trial compared a topical vs. a destructive intervention. Conversely, 44 of the 55 trials compared interventions within the same treatment class and 9 of 55 trials compared surgical vs. destructive interventions. In most trials, selection of same-class comparators was not necessitated by the type of BCC lesions (nonaggressive superficial or nodular vs. aggressive, infiltrative, morpheic BCCs, P = 0.155) or their location (face vs. nonfacial, P = 0.137). CONCLUSION This is the first time that an evaluation of network geometry is applied to address issues of comparisons between different families of interventions that belong to different specialties and practices (medical vs. surgical). Previous evaluations of homophily have addressed different families of interventions, in which all interventions are medical (drugs) and performed in the same health-care settings. The noncommunicating bodies of evidence between medical and surgical interventions that we document highlight a problem of unnecessary sequestration of the evidence and the corresponding health-care practices.
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Affiliation(s)
- David D Kim
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St, Redwood City, CA 94063, USA
| | - Jean Y Tang
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St, Redwood City, CA 94063, USA
| | - John P A Ioannidis
- Stanford Prevention Research Center, Department of Medicine, Medical School Office Building, Room X306, 1265 Welch Rd, Stanford, CA 94305, USA; Department of Health Research and Policy, Stanford University School of Medicine, Redwood Building T152, 150 Governor's Lane, Stanford, CA 94305, USA.
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14
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Terapia fotodinámica versus imiquimod. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:488-501. [DOI: 10.1016/j.ad.2011.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 09/27/2011] [Accepted: 10/02/2011] [Indexed: 11/22/2022] Open
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15
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Serra-Guillén C, Nagore E, Guillén C. Photodynamic Therapy vs Imiquimod. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2012.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Attili SK, Ibbotson SH, Fleming C. 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. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2012; 28:68-79. [DOI: 10.1111/j.1600-0781.2011.00640.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Sasi K. Attili
- Department of Dermatology & Photobiology; Ninewells Hospital & Medical School; Dundee; UK
| | - Sally H. Ibbotson
- Department of Dermatology & Photobiology; Ninewells Hospital & Medical School; Dundee; UK
| | - Colin Fleming
- Department of Dermatology & Photobiology; Ninewells Hospital & Medical School; Dundee; UK
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