Basal cell carcinoma

基底细胞癌
  • 文章类型: Letter
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  • 文章类型: Journal Article
    总结目前皮肤癌的治疗方法,日本皮肤癌协会发布了第一个皮肤癌指南,包括黑色素瘤,鳞状细胞癌,基底细胞癌(BCC),和Paget的乳房外疾病,2007年。这些准则于2015年修订。在这里,我们介绍2021版日本BCC临床指南的英文版.在最新版本中,所有程序均根据建议分级进行,评估,开发和评估系统。选择无法回答的临床问题进行进一步分析。全面的文献检索,系统审查,每个临床问题的建议由皮肤科医生组成的多学科专家小组确定,整形和重建外科医生,还有病理学家.手术切除是治疗BCC的金标准。放射治疗或局部治疗,除了手术切除,已在某些情况下使用。不可切除或转移性BCC患者需要全身治疗。新型特工,如免疫应答调节剂或刺猬通路抑制剂,正在世界范围内出现BCC的治疗方法。基于这些观点,四个相关的临床问题,手术切除,放射治疗,局部治疗,和全身治疗,本报告旨在帮助临床医生为患者选择合适的治疗方法。
    To summarize the current therapies for skin cancers, the Japanese Skin Cancer Society issued the first guidelines for skin cancers, including melanoma, squamous cell carcinoma, basal cell carcinoma (BCC), and extramammary Paget\'s disease, in 2007. These guidelines were revised in 2015. Herein, we present the English version of the 2021 edition of the Japanese clinical guidelines for BCC. In the latest edition, all procedures were performed according to the Grading of Recommendations, Assessment, Development and Evaluation systems. The clinical questions that could not be answered were selected for further analysis. A comprehensive literature search, systematic review, and recommendations for each clinical question were determined by a multidisciplinary expert panel comprising dermatologists, a plastic and reconstructive surgeon, and a pathologist. Surgical resection is the gold-standard therapy of BCC. Radiotherapy or topical treatments, other than surgical resection, have been used in some cases. Patients with unresectable or metastatic BCC require systemic therapy. Novel agents, such as immune response modifiers or hedgehog pathway inhibitors, are emerging worldwide for the treatment of BCC. Based on these viewpoints, four relevant clinical questions regarding, surgical resection, radiotherapy, topical treatment, and systemic therapy, were raised in this report that aims to help clinicians select suitable therapies for their patients.
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  • 文章类型: Practice Guideline
    用于描述黑素细胞和非黑素细胞病变的反射共聚焦显微镜(RCM)发现的术语已在英语中标准化。我们召集了一个讲西班牙语的RCM专家小组,并使用Delphi方法就西班牙术语最能描述这种情况下的RCM发现寻求共识。专家同意52个术语:28个用于黑色素细胞病变,24个用于非黑色素细胞病变。由此产生的术语将有助于均匀化,从而更好地理解结构,临床登记处更标准化的描述,和皮肤科医生之间交换的临床报告更容易解释。
    The terminology used to describe reflectance confocal microscopy (RCM) findings in both melanocytic and nonmelanocytic lesions has been standardized in English. We convened a panel of Spanish-speaking RCM experts and used the Delphi method to seek consensus on which Spanish terms best describe RCM findings in this setting. The experts agreed on 52 terms: 28 for melanocytic lesions and 24 for nonmelanocytic lesions. The resulting terminology will facilitate homogenization, leading to a better understanding of structures, more standardized descriptions in clinical registries, and easier interpretation of clinical reports exchanged between dermatologists.
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  • 文章类型: Practice Guideline
    用于描述黑素细胞和非黑素细胞病变的反射共聚焦显微镜(RCM)发现的术语已在英语中标准化。我们召集了一个讲西班牙语的RCM专家小组,并使用Delphi方法就西班牙术语最能描述这种情况下的RCM发现寻求共识。专家同意52个术语:28个用于黑色素细胞病变,24个用于非黑色素细胞病变。由此产生的术语将有助于均匀化,从而更好地理解结构,临床登记处更标准化的描述,和皮肤科医生之间交换的临床报告更容易解释。
    The terminology used to describe reflectance confocal microscopy (RCM) findings in both melanocytic and nonmelanocytic lesions has been standardized in English. We convened a panel of Spanish-speaking RCM experts and used the Delphi method to seek consensus on which Spanish terms best describe RCM findings in this setting. The experts agreed on 52 terms: 28 for melanocytic lesions and 24 for nonmelanocytic lesions. The resulting terminology will facilitate homogenization, leading to a better understanding of structures, more standardized descriptions in clinical registries, and easier interpretation of clinical reports exchanged between dermatologists.
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  • 文章类型: Journal Article
    基底细胞癌(BCC)是最常见的癌症,对公共卫生负担和社会成本有很大影响。尽管BCC患者的总体预后良好,如果允许病变进展,或者在一小部分具有内在攻击性生物学行为的病例中,它会导致局部传播和显著的发病率,和常规治疗(手术和放疗)可能是具有挑战性的。当BCC不适合具有合理治疗意图的手术或放疗时,或者当转移扩散发生时,可以使用Hedgehog抑制剂进行全身治疗。制定了这些指导方针,应用等级方法,代表意大利医学肿瘤学家协会(AIOM)协助临床医生治疗BCC患者。它们包含有关诊断的建议,治疗和随访,从原始肿瘤到局部晚期或转移性肿瘤,解决由AIOM和其他国家科学协会选出的专家小组认为是优先事项的BCC管理方面。在日常临床实践中使用这些指南应改善患者护理。
    Basal cell carcinoma (BCC) is the most common form of cancer, with a high impact on the public health burden and social costs. Despite the overall prognosis for patients with BCC being excellent, if lesions are allowed to progress, or in a small subset of cases harboring an intrinsically aggressive biological behavior, it can result in local spread and significant morbidity, and conventional treatments (surgery and radiotherapy) may be challenging. When a BCC is not amenable to either surgery or radiotherapy with a reasonable curative intent, or when metastatic spread occurs, systemic treatments with Hedgehog inhibitors are available. These guidelines were developed, applying the GRADE approach, on behalf of the Italian Association of Medical Oncologists (AIOM) to assist clinicians in treating patients with BCC. They contain recommendations with regard to the diagnosis, treatment and follow-up, from primitive tumors to those locally advanced or metastatic, addressing the aspects of BCC management considered as priorities by a panel of experts selected by AIOM and other national scientific societies. The use of these guidelines in everyday clinical practice should improve patient care.
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  • 文章类型: Journal Article
    基底细胞癌(BCC)是白人人群中最常见的恶性肿瘤。来自欧洲皮肤肿瘤协会(EADO)的多学科专家,欧洲皮肤病学论坛,欧洲放射治疗和肿瘤学会(ESTRO),欧洲医学界联盟,欧洲皮肤病和性病学会提出了关于BCC诊断和治疗的最新建议。根据新的EADO临床分类,BCC分为“易于治疗”(常见)和“难以治疗”。诊断基于临床-皮肤镜特征,尽管在模棱两可的病变中必须进行组织病理学确认。BCC的一线治疗是完全手术。应在高风险和复发性BCC中提供显微控制手术,和位于关键解剖部位的BCC。对于低风险的浅表BCC患者,可以考虑局部治疗和破坏性方法。光动力疗法是浅层和低风险结节性BCC的有效治疗方法。“难以治疗的”BCC的管理应由多学科肿瘤委员会讨论。刺猬抑制剂(HHI),vismodegib或sonidegib,应提供给局部晚期和转移性BCC患者。抗PD1抗体(cemiplimab)的免疫治疗是疾病进展患者的二线治疗,禁忌症,或不耐受HHI治疗。对于不适合或拒绝手术的患者,放射治疗是一种有效的替代方法。尤其是老年患者。当手术或放疗禁忌时,可以提供电化学疗法。在Gorlin患者中,需要定期皮肤检查以早期诊断和治疗BCC。建议对高危BCC患者进行长期随访,多个BCC,和戈林综合症。
    Basal cell carcinoma (BCC) is the most common malignant tumour in white populations. Multidisciplinary experts from European Association of Dermato-Oncology (EADO), European Dermatology Forum, European Society for Radiotherapy and Oncology (ESTRO), Union Européenne des Médecins Spécialistes, and the European Academy of Dermatology and Venereology developed updated recommendations on diagnosis and treatment of BCC. BCCs were categorised into \'easy-to-treat\' (common) and \'difficult-to-treat\' according to the new EADO clinical classification. Diagnosis is based on clinico-dermatoscopic features, although histopathological confirmation is mandatory in equivocal lesions. The first-line treatment of BCC is complete surgery. Micrographically controlled surgery shall be offered in high-risk and recurrent BCC, and BCC located on critical anatomical sites. Topical therapies and destructive approaches can be considered in patients with low-risk superficial BCC. Photodynamic therapy is an effective treatment for superficial and low-risk nodular BCCs. Management of \'difficult-to-treat\' BCCs should be discussed by a multidisciplinary tumour board. Hedgehog inhibitors (HHIs), vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCC. Immunotherapy with anti-PD1 antibodies (cemiplimab) is a second-line treatment in patients with a progression of disease, contraindication, or intolerance to HHI therapy. Radiotherapy represents a valid alternative in patients who are not candidates for or decline surgery, especially elderly patients. Electrochemotherapy may be offered when surgery or radiotherapy is contraindicated. In Gorlin patients, regular skin examinations are required to diagnose and treat BCCs at an early stage. Long-term follow-up is recommended in patients with high-risk BCC, multiple BCCs, and Gorlin syndrome.
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  • 文章类型: Journal Article
    背景:尽管光学相干断层扫描(OCT)广泛用于角质形成细胞癌的成像,我们对基底细胞癌(BCC)的特征性OCT特征缺乏专家共识,一组经过国际审查的OCT术语来描述各种BCC亚型,和教育需求评估。
    目的:为了识别OCT图像中的相关BCC特征,根据专家小组的意见提出术语,并为OCT学员确定BCC特定课程的内容。
    方法:经过三轮,我们在2020年3月至9月间对BCC特征和术语进行了Delphi共识研究.在第一轮中,专家们被要求提出可由OCT辨别的BCC亚型,为每个建议的BCC子类型提供OCT图像特征,并为特定于BCC的OCT培训课程提供内容建议。如果BCC-OCT功能的一致性超过67%,该功能已被接受并包含在最终审查中。在第二轮中,专家必须重新评估一致性低于67%的特征,并对浅层BCC的十个最相关的BCCOCT图像特征进行排名,结节性BCC和浸润型和morphormBCC亚型。在最后一轮,专家收到了OCT-BCC共识清单进行最终审查,评论和确认。
    结果:Delphi包括6位主要意见领袖和22位专家。在三个OCTBCC图像特征的术语上发现了共识:(i)低反射区域,(ii)超反射区域和(iii)卵形结构。Further,参与者对结节的十个最相关的图像特征进行了排名,肤浅的,浸润性和morpheapformBCC。已定义了BCCOCT成像课程的目标群体和关键组件。
    结论:我们为BCC和首选术语建立了一组OCT图像特征。基于专家建议的综合课程将有助于在临床和研究环境中实施BCC的OCT成像。
    BACKGROUND: Despite the widespread use of optical coherence tomography (OCT) for imaging of keratinocyte carcinoma, we lack an expert consensus on the characteristic OCT features of basal cell carcinoma (BCC), an internationally vetted set of OCT terms to describe various BCC subtypes, and an educational needs assessment.
    OBJECTIVE: To identify relevant BCC features in OCT images, propose terminology based on inputs from an expert panel and identify content for a BCC-specific curriculum for OCT trainees.
    METHODS: Over three rounds, we conducted a Delphi consensus study on BCC features and terminology between March and September 2020. In the first round, experts were asked to propose BCC subtypes discriminable by OCT, provide OCT image features for each proposed BCC subtypes and suggest content for a BCC-specific OCT training curriculum. If agreement on a BCC-OCT feature exceeded 67%, the feature was accepted and included in a final review. In the second round, experts had to re-evaluate features with less than 67% agreement and rank the ten most relevant BCC OCT image features for superficial BCC, nodular BCC and infiltrative and morpheaphorm BCC subtypes. In the final round, experts received the OCT-BCC consensus list for a final review, comments and confirmation.
    RESULTS: The Delphi included six key opinion leaders and 22 experts. Consensus was found on terminology for three OCT BCC image features: (i) hyporeflective areas, (ii) hyperreflective areas and (iii) ovoid structures. Further, the participants ranked the ten most relevant image features for nodular, superficial, infiltrative and morpheaform BCC. The target group and the key components for a curriculum for OCT imaging of BCC have been defined.
    CONCLUSIONS: We have established a set of OCT image features for BCC and preferred terminology. A comprehensive curriculum based on the expert suggestions will help implement OCT imaging of BCC in clinical and research settings.
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  • 文章类型: Journal Article
    Basal cell carcinoma (BCC) is the most common skin malignancy afflicting modern Australian society. The most influential response to rising BCC incidence rates has been through public health primary prevention campaigns (PPC) which have persevered since the 1980s. These campaigns are widely heralded a success but clinical data quantifying these benefits are limited due to an absence of legislation around BCC reporting. A non-systematic search of the literature was conducted identifying articles investigating the incidence and clinical characteristics of BCC over the past 40 years, as well as the economic viability of the PPC. There is robust evidence supporting stabilizing rates of BCC incidence in Australia. Similarly, multiple studies have shown the economic benefits of PPC through cost analysis. Anatomical and histological data are reported inconsistently, consequently limiting analysis of changes in BCC clinical characteristics. The consensus throughout the literature is that BCC is a significant public health issue that requires legislative reform. This narrative literature review serves to highlight the need for statutory changes around non-melanocytic skin cancer data collection to enable appropriate analysis and evaluation of current management strategies.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    角质形成细胞癌(KC,以前的非黑色素瘤皮肤癌)代表了全球最常见的癌症。虽然通常使用手术治疗,各种放射治疗技术,包括外波束和近距离放射治疗。因此,美国近距离放射治疗学会就近距离放射治疗在KCs治疗中的应用发表了最新的共识声明.
    具有皮肤癌和近距离放射治疗专业知识的医师和物理学家为适当的患者选择达成了共识。数据,剂量测定法,在文献检索和临床经验的基础上,利用皮肤近距离放射治疗和技术。
    患者选择指南,评估,和剂量/分割时间表,以优化接受近距离放射治疗的KC患者的结局。电子近距离放射治疗的研究正在兴起,尽管可获得的长期数据或比较数据有限。基于放射性核素的近距离放射治疗是具有多种可用技术的小KC患者的适当选择。
    皮肤近距离放射治疗代表了适当选择的KC患者的标准护理选择。基于放射性核素的近距离放射治疗是一种成熟的技术;然而,目前的建议是,由于缺乏成熟的数据,在前瞻性临床试验或注册中对KC使用电子近距离放射治疗.
    Keratinocyte carcinoma (KC, previously nonmelanoma skin cancer) represents the most common cancer worldwide. While surgical treatment is commonly utilized, various radiation therapy techniques are available including external beam and brachytherapy. As such, the American Brachytherapy Society has created an updated consensus statement regarding the use of brachytherapy in the treatment of KCs.
    Physicians and physicists with expertise in skin cancer and brachytherapy created a consensus statement for appropriate patient selection, data, dosimetry, and utilization of skin brachytherapy and techniques based on a literature search and clinical experience.
    Guidelines for patient selection, evaluation, and dose/fractionation schedules to optimize outcomes for patients with KC undergoing brachytherapy are presented. Studies of electronic brachytherapy are emerging, although limited long-term data or comparative data are available. Radionuclide-based brachytherapy represents an appropriate option for patients with small KCs with multiple techniques available.
    Skin brachytherapy represents a standard of care option for appropriately selected patients with KC. Radionuclide-based brachytherapy represents a well-established technique; however, the current recommendation is that electronic brachytherapy be used for KC on prospective clinical trial or registry because of a paucity of mature data.
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