PDF(Pubmed)
Abstract：
Background: The rising incidence of Basal Cell Carcinoma (BCC), especially among individuals with significant sun exposure, underscores the need for effective and minimally invasive treatment alternatives. Traditional surgical approaches, while effective, often result in notable cosmetic and functional limitations, particularly for lesions located on the face. This study explores High-Intensity Focused Ultrasound (HIFU) as a promising, non-invasive treatment option that aims to overcome these challenges, potentially revolutionizing BCC treatment by offering a balance between efficacy and cosmetic outcomes. Methods: Our investigation enrolled 8 patients, presenting a total of 15 BCC lesions, treated with a 20 MHz HIFU device. The selection of treatment parameters was precise, utilizing probe depths from 0.8 mm to 2.3 mm and energy settings ranging from 0.7 to 1.3 Joules (J) per pulse, determined by the lesion\'s infiltration depth as assessed via pre-procedure ultrasonography. A key component of our methodology included dermatoscopic monitoring, which allowed for detailed observation of the lesions\' response to treatment over time. Patient-reported outcomes and satisfaction levels were systematically recorded, providing insights into the comparative advantages of HIFU. Results: Initial responses after HIFU treatment included whitening and edema, indicative of successful lesion ablation. Early post-treatment observations revealed minimal discomfort and quick recovery, with crust formation resolving within two weeks for most lesions. Over a period of three to six months, patients reported significant improvement, with lesions becoming lighter and blending into the surrounding skin, demonstrating effective and aesthetically pleasing outcomes. Patient satisfaction surveys conducted six months post-treatment revealed high levels of satisfaction, with 75% of participants reporting very high satisfaction due to minimal scarring and the non-invasive nature of the procedure. No recurrences of BCC were noted, attesting to the efficacy of HIFU as a treatment option. Conclusions: The findings from this study confirm that based on dermoscopy analysis, HIFU is a highly effective and patient-preferred non-invasive treatment modality for Basal Cell Carcinoma. HIFU offers a promising alternative to traditional surgical and non-surgical treatments, reducing the cosmetic and functional repercussions associated with BCC management. Given its efficacy, safety, and favorable patient satisfaction scores, HIFU warrants further investigation and consideration for broader clinical application in the treatment of BCC, potentially setting a new standard in dermatologic oncology care. This work represents a pilot study that is the first to describe the use of HIFU in the treatment of BCC.
摘要：
背景：基底细胞癌（BCC）的发病率上升，尤其是在有大量阳光照射的个体中，强调了对有效和微创治疗替代方案的需求。传统的手术方法，虽然有效，通常会导致明显的化妆品和功能限制，特别是位于面部的病变。这项研究探讨了高强度聚焦超声（HIFU）作为一种有前途的，旨在克服这些挑战的非侵入性治疗选择，通过在疗效和美容结果之间提供平衡，可能彻底改变BCC治疗。方法：我们的调查纳入了8例患者，总共有15个BCC病变，用20MHzHIFU装置处理。治疗参数的选择是精确的，利用0.8mm至2.3mm的探头深度和每个脉冲0.7至1.3焦耳（J）的能量设置，根据术前超声评估的病变浸润深度确定。我们方法的一个关键组成部分包括皮肤镜监测，这允许随着时间的推移详细观察病变对治疗的反应。系统记录患者报告的结果和满意度水平，提供对HIFU比较优势的见解。结果：HIFU治疗后的初始反应包括美白和水肿，指示成功的病灶消融。治疗后的早期观察显示，不适程度最小，恢复迅速，对于大多数病变，地壳形成在两周内解决。在三到六个月的时间里，患者报告显着改善，病变变得更轻，并混入周围的皮肤，展示有效和美观的结果。治疗后六个月进行的患者满意度调查显示满意度很高，75％的参与者报告非常高的满意度，由于最小的疤痕和程序的非侵入性。未发现BCC复发，证明HIFU作为治疗选择的有效性。结论：这项研究的结果证实，基于皮肤镜分析，HIFU是基底细胞癌的一种非常有效且患者首选的非侵入性治疗方式。HIFU为传统手术和非手术治疗提供了一个有希望的替代方案，减少与BCC管理相关的化妆品和功能影响。鉴于其功效,安全,和良好的患者满意度评分，HIFU值得进一步研究和考虑在BCC治疗中更广泛的临床应用，可能在皮肤科肿瘤护理中树立新标准。这项工作代表了一项初步研究，该研究首次描述了HIFU在BCC治疗中的用途。
