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Ablative fractional laser with topical fluorouracil effective for some nonmelanoma skin cancers

A noninvasive treatment with ablative fractional laser–assisted topical fluorouracil was effective for superficial basal cell carcinoma and primary squamous cell carcinoma in situ, according to recent study data.

“The effectiveness of topical fluorouracil in treating [superficial basal cell carcinoma (BCC)] and [squamous cell carcinoma (SCC) in situ] in nonresearch settings is variable,” Sarah H. Hsu, MD, from the department of dermatology at Boston Medical Center and colleagues wrote. “The long-term outcomes remain unknown… to improve the clinical effectiveness of topical fluorouracil.”

In a previous study, the researchers found short-term success of ablative fractional laser–assisted delivery of topical fluorouracil in the treatment of superficial BCC and SCC in situ. This follow-up study evaluated long-term outcomes of tumor clearance among the study cohort more than 9 months post-treatment.

The researchers treated 30 patients with primary superficial BCC or SCC in situ less than 2 centimeters on the skin with ablative fractional laser and an application of topical 5-fluorouracil 5% under an occlusive dressing for 7 days. After a mean follow-up time of 15 months, 20 of the 26 patients who achieved tumor clearance at 4 to 8 weeks post-treatment underwent shave biopsy to verify histologic clearance.

The overall treatment success rate was 79% (95% CI, 67-96). The success rate for those with SCC in situ was 92% and the success rate was 67% for superficial BCC. The outcome of treatment was not notably affected by tumor location or size.

“The initial response to treatment may predict long-term outcome, as most of the treatment failures occurred at 4 to 8 weeks… careful follow-up within the first few months after treatment is advisable,” the researchers wrote. “As the incidence of nonmelanoma skin cancers increases with an aging population, more convenient and cost-effective treatment alternatives are needed, especially for superficial tumors with low risk of recurrence.”– by Savannah Demko

Disclosure: The researchers report no relevant financial disclosures.