Ablative Fractional Laser-Assisted Topical Fluorouracil for the Treatment of Superficial Basal Cell Carcinoma and Squamous Cell Carcinoma In Situ: A Follow-Up Study

Dermatol Surg. 2016 Sep;42(9):1050-3. doi: 10.1097/DSS.0000000000000814.

Abstract

Background: The authors previously reported the safety and short-term efficacy of ablative fractional laser (AFXL)-assisted delivery of topical fluorouracil in the treatment of superficial basal cell carcinoma (sBCC) and squamous cell carcinoma in situ (SCCis).

Objective: This follow-up study was conducted to assess whether tumor clearance was sustained in this cohort of patients at >9 months post-treatment.

Methods: Thirty primary sBCC or SCCis <2 cm on the trunk or extremities were treated with AFXL and a single application of topical 5-fluorouracil 5% under occlusion for 7 days. Among the 26 patients who achieved tumor clearance at 4 to 8 weeks post-treatment, 20 patients presented for this follow-up study and underwent shave biopsy to confirm histologic clearance. Mean follow-up time was 15 months.

Results: Considering those who had persistent tumor at 4 to 8 weeks post-treatment and those who presented for follow-up at >9 months post-treatment, overall treatment success was 79% (95% confidence interval: 67%-96%), with 92% (11/12) for SCCis and 67% (8/12) for sBCC. Neither the tumor location nor size significantly impacted treatment outcome (p = .96 and 0.87, respectively).

Conclusion: Ablative fractional laser-assisted topical fluorouracil is a reasonable noninvasive treatment option for primary SCCis and sBCC, especially for lesions located in areas where self-application is not possible, or when clinician-administered therapy is preferred.

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / administration & dosage*
  • Carcinoma in Situ / drug therapy*
  • Carcinoma in Situ / pathology
  • Carcinoma, Basal Cell / drug therapy*
  • Carcinoma, Basal Cell / pathology
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / pathology
  • Drug Delivery Systems
  • Extremities
  • Fluorouracil / administration & dosage*
  • Follow-Up Studies
  • Humans
  • Lasers, Gas / therapeutic use*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / pathology
  • Torso
  • Treatment Outcome
  • Tumor Burden

Substances

  • Antimetabolites, Antineoplastic
  • Fluorouracil