Squamous cell carcinoma Treatment

Squamous cell carcinoma
Treatment
Squamous cell carcinoma non-surgical options for treatment include topical chemotherapy, topical immune response modulators, photodynamic therapy, radiotherapy and systemic chemotherapy. The use of topical therapy and phototherapy is limited to premalignant lesions in situ: actinic keratosis. Radiation therapy is a primary treatment option for patients when surgery is not possible and adjunctive therapy for patients with metastases.
Topical Chemotherapy 5-fluorouracil topical formulations are available for the treatment of actinic keratoses and superficial basal carcinoma. Treatment of squamous cell carcinoma in situ is possible.
Topical immune response modulators. Imiquimod is a imidazoquinolin which enhances the immune response by inducing proinflammatory cytokines. It is approved to treat genital warts, actinic keratoses and superficial basal cell carcinoma. Imiquimod cream was effective I look Bowen disease therapy in combination with 5-fluorouracil. But applied to large areas have side effects of flu.
  Photodynamic therapy. Imlica photodynamic therapy treatment followed by application of a xpunerea fotosintetizator a source of light. The resulting photochemical reaction causes inflammation and destruction of the targeted lesion. It is used mainly for multiple actinic keratoses. Not recommended for invasive squamous cell carcinoma.
Radiotherapy. This gives the advantage to avoid deformity and trauma through a surgical procedure. Cure rate for T1 is 95%. However there are some disadvantages: it is expensive, requires a prolonged time, shows the irradiated site irritation, erythema, erosions, alopecia and pain that requires narcotic analgesia. Although the initial cosmetic result is good long-term evolution is fatal, with an increased risk of developing skin carcinoma or sarcoma late in life. Radiation does not involve a border control and histologic cure rate is low compared to surgery. It is used routinely as an adjunct to surgery in cases of lymphatic metastasis.
Systemic chemotherapy. many agents have been tried to treat metastases. Capecitabine, an oral form of 5-fluorouracil in combination with interferon alfa has shown efficacy in the treatment of advanced cutaneous forms.
Surgical therapy.
Most squamous cell carcinomas treated by surgical or destructive methods.
Cryotherapy. Technique is safe and inexpensive liquid nitrogen for removal of squamous cell carcinoma in situ. Cure rate at 5 years is 95%. Cryosurgery is used routinely in actinic keratoses. It is used for invasive forms of profound proportions due to tumor can not be eradicated. Associated Tiscurile include transient pain, swelling, veziculizare. Hypopigmentation and alopecia are also common and can be permenente.
Electrodesicarea and curettage. It is a simple technique that can be folocita to treat low-risk squamous cell carcinoma of the trunk and extremities. Can be used to treat high-risk superficial invasive carcinomas. It is suitable for locating on the eyelids, genitalia, lips and ears. The technique is based on tumor margins delinerea curette. The major disadvantage is the lack of edge control. Recurrence of tumor eradication is the absence of tumor cells in the dermis and hair follicles.
Excision with conventional margins. Standard excision with permanent section tissue therapy is an excellent, well tolerated primitive squamous cell carcinoma. Cure rate for T1 lesions is 99%, this drops to 77% for recurrent carcinoma. We recommend a 4-mm margin of tissue for low-risk lesions on the trunk and extremities. For lesions over 2 cm in grease and invasive high-risk areas (face, ears, scalp, genitals, hands, feet) indicate a margin of 6 mm in normal tissue. Because the cosmetic outcome and functional impact of such wide margins, tumors in these categories are removed by Mohs microsurgery.
Mohs micrographic surgery. It is a special technique for skin cancers Heights counted. The elective procedure in squamous cell carcinoma in the taking of tissue is necessary for evil defined tumors and tumors with high risk. The advantage is the ability to examine 100% histological excision margins.
Prophylaxis
Squamous carcinomas Prevention is best accomplished by limiting UV exposure, wearing protective clothing, use sunscreen. Treatment of actinic keratoses and squamous cell carcinoma in situ carcinoma may prevent further inaziv. Chimioprotectia retinoizisistemici is effective to reduce the number of squamous carcinomas in immunocompetent and immunocompromised patients in November. Recent studies show that use of oral acitretin is more effective than tretinoin. Treatment of recurrent tumors should be indefinite because there discontinuing prophylaxis.
Prognosis
Most carcinaome carcinoma treated with a hope of healing. Risk of lymphatic or distant metastases is 2-6%. A subset of carriers carcinaome increased risk of local recurrence, distant metastasis or lymphatic system, lungs and death. When carcinaomul metastasized squamous happens 5 years after diagnosis and involves first draining nodule. Generally carcinoma metastases forehead, temples, eyelids, cheeks and ears appear in lymph parotid gland metastases from lip and perioral and mandibular submental occur. Once metastases have occurred five years survival rate is 35%. The prognosis is negative immunocompromised, with multiple lymphatic metastases, or more than 3 cm cervical lymph nodule.