[基底细胞癌的治疗现状]。

IF 0.6 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Deutsche Medizinische Wochenschrift Pub Date : 2023-09-01 Epub Date: 2023-08-23 DOI:10.1055/a-1958-2603
Manuel Krieter, Erwin Schultz
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引用次数: 0

摘要

对于基底细胞癌的治疗,风险分层的主要表现越来越重要,这对进一步的诊断和治疗步骤至关重要。各种非侵入性方法可用于确认临床诊断。在不清楚的情况下,建议对诊断进行组织学确认。对于移位不良的病变,应在术前对肿瘤区域进行横断面成像,以排除骨浸润。治疗的黄金标准仍然是手术,如果可能的话,应该通过显微控制手术进行。此外,还有其他治疗方法,如放疗或多种局部治疗选择(光动力疗法、冷冻疗法或应用5-氟尿嘧啶或咪喹莫特),这些方法可用于某些情况。对于晚期或转移性基底细胞癌,也有刺猬抑制剂形式的有效药物,目前在疗效和不良事件处理方面已有几年的应用经验。使用PD-1抑制剂cemiplimab,自2021年6月以来,对不可手术或转移性肿瘤的进一步治疗选择已经可用。最重要的预防措施是对已经受影响的个体进行持续的纺织品或化学紫外线防护。此外,烟酰胺和塞来昔布可口服预防。对于随访,目前的S2k指南建议定期自我监测和标准化医疗检查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Current Management of Basal Cell Carcinoma].

For the management of basal cell carcinoma, the primary performance of a risk stratification, which is decisive for the further diagnostic and therapeutic steps, is becoming increasingly important.Various non-invasive methods are available to confirm the clinical diagnosis. Histological confirmation of the diagnosis is recommended in unclear cases. In poorly displaced lesions, preoperative cross-sectional imaging of the tumor area should be performed to exclude osseous infiltration.The gold standard in treatment remains surgery, which should be performed by means of micrographically controlled surgery if possible. In addition, there are other therapeutic methods such as radiotherapy or a number of topical therapy options (photodynamic therapy, cryotherapy or application of 5-fluorouracil or imiquimod), which can be used in certain cases. Also for advanced or metastatic basal cell carcinoma, effective drugs are available in the form of the hedgehog inhibitors, for which there is now several years of application experience with regard to efficacy and handling of adverse events. With the PD-1 inhibitor cemiplimab, a further therapeutic option for non-operable or metastatic tumors has been available since June 2021.The most important preventive measure is consistent textile or chemical UV protection in already affected individuals. In addition, nicotinamide and celecoxib can be used orally for prevention. For follow-up, the current S2k guideline recommends regular self-monitoring and standardized medical check-ups.

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来源期刊
Deutsche Medizinische Wochenschrift
Deutsche Medizinische Wochenschrift 医学-医学:内科
CiteScore
0.80
自引率
0.00%
发文量
432
审稿时长
3-6 weeks
期刊介绍: Ein Schwerpunktthema - verschiedene Perspektiven Mit vielen praktischen Tipps und konkreten Handlungsanweisungen. Kurz und prägnant: Aktuell informiert Interessante Nachrichten für Sie zusammengefasst und von Experten kommentiert. Fundiertes Fachwissen - für Einsteiger und Profis Ein bunter Mix aus Übersichten, Fallbeispielen, Kasuistiken und Schritt-für-Schritt-Anleitungen. Blick über den Tellerrand Erweitern Sie Ihren Fokus über das reine Fachwissen hinaus mit "Medizin im Kontext".
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