瘢痕疙瘩是良性的,纤维增生性真皮肿瘤,通常发生在创伤后,在深色皮肤类型中更常见。已经采用了许多治疗方法来治疗瘢痕疙瘩;然而,没有一个金本位制的方法。五氟尿嘧啶,一种有效的化疗药物,已经成为一种有希望的治疗选择。因此,这个系统的审查,使用系统审查和荟萃分析(PRISMA)指南的首选报告项目,专注于提供使用5-氟尿嘧啶治疗瘢痕疙瘩的广泛概述。40项研究(2325例患者)符合纳入标准,并调查了5-氟尿嘧啶用于瘢痕疙瘩治疗,19项研究(1043例患者),包括5-氟尿嘧啶单药治疗组。五氟尿嘧啶单一疗法显示出一致的瘢痕疙瘩改善,在不同解剖区域注射>254个瘢痕疙瘩。五氟尿嘧啶单一疗法最常与病灶内曲安奈德相比,利用患者和观察者疤痕评估量表和温哥华疤痕量表。评估的最常见的瘢痕疙瘩参数是身高,尺寸,volume,宽度,长度,硬结,瘙痒,和红斑.五-氟尿嘧啶单一疗法表现出实质性的改善,73%的患者平均体重改善>25%,67%的患者改善>50%。5-氟尿嘧啶单药治疗后27周复发率为16%。限制包括潜在的选择偏差,语言限制,和研究之间的异质性数据分析。总的来说,我们的发现强调了5-氟尿嘧啶单药治疗瘢痕疙瘩的潜在有效性,具有令人鼓舞的安全性。需要更大的前瞻性试验来确定治疗瘢痕疙瘩的最佳疗法或联合疗法。这份治疗方案的详细汇编,结果,复发率是进一步研究和临床应用的宝贵资源。
Keloids are benign, fibroproliferative dermal tumours, often arising after trauma, that are more common in darker skin types. Numerous therapeutic options have been employed for the treatment of
keloids; however, there is no one gold standard approach. Five-fluorouracil, a potent chemotherapeutic agent, has emerged as a promising therapeutic option. Therefore, this systematic review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focused on providing a broad overview of the use of 5-fluorouracil for the management of
keloids. Forty studies (2325 patients) met inclusion criteria and investigated 5-fluorouracil for keloid management, with 19 studies (1043 patients) including a 5-fluorouracil monotherapy group. Five-fluorouracil monotherapy demonstrated consistent keloid improvement with >254
keloids injected across various anatomical regions. Five-fluorouracil monotherapy was most often compared to intralesional triamcinolone acetonide, utilizing the Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale. The most common keloid parameters assessed were height, size, volume, width, length, induration, pruritus, and erythema. Five-fluorouracil monotherapy exhibited substantial improvements, with weight averages of 73% of patients experiencing >25% improvement and 67% achieving >50% improvement. Relapse rate was 16% at 27 weeks after 5-fluorouracil monotherapy treatment. Limitations included potential selection bias, language restrictions, and heterogenous data analysis among studies. Overall, our findings underscore the potential effectiveness of 5-fluorouracil monotherapy in the management of
keloids, with an encouraging safety profile. Larger prospective trials are needed to determine optimal therapy or combination therapy for the management of keloids. This detailed compilation of treatment protocols, outcomes, and relapse rates stand as a valuable resource for further research and clinical applications.