0

I wonder how effective topical fluorouracil is to treat facial superficial basal cell carcinoma (BCC).

What I have found so far doesn't give any source supporting their claims or I cannot access them:

https://bpac.org.nz/2017/skin-cancer.aspx:

Apply twice daily, for six to 12 weeks; N.B. Fluorouracil is generally only used to treat small, very superficial BCC, and treatment is associated with a high rate of recurrence

https://www.drugs.com/monograph/fluorouracil-topical.html#ra:

Used topically for the treatment of superficial basal cell carcinoma when conventional methods are impractical (e.g., in patients with multiple lesions or difficult treatment sites).a b g Efficacy not established for treatment of other basal cell carcinomas; establish diagnosis before initiating treatment. [references a b g]

When lesions are isolated and easily accessible, conventional techniques (e.g., surgery, curettage and dessication, cryotherapy) are preferred because they have a higher response rate. [references a b g]

(I don't have access to references a b g)

{1,2} focus on actinic keratoses, e.g. from {2}:

The results of this meta-analysis show that both imiquimod and 5-fluorouracil are effective methods for the treatment of actinic keratosis and provide a useful alternative to cryotherapy. However, this analysis suggests that imiquimod may have higher efficacy than 5-fluorouracil for actinic keratosis lesions located on the face and scalp and therefore provides another option to dermatologists.


References:

  • {1} Tanghetti, Emil, and Philip Werschler. "Comparison of 5% 5-fluorouracil cream and 5% imiquimod cream in the management of actinic keratoses on the face and scalp." Journal of drugs in dermatology: JDD 6, no. 2 (2007): 144-147. https://pubmed.ncbi.nlm.nih.gov/17373172/
  • {2} Gupta, Aditya K., Valerie Davey, and Heather Mcphail. "Evaluation of the effectiveness of imiquimod and 5-fluorouracil for the treatment of actinic keratosis: Critical review and meta-analysis of efficacy studies." Journal of cutaneous medicine and surgery 9, no. 5 (2005): 209-214. https://pubmed.ncbi.nlm.nih.gov/16502198/
3
  • I have had two basal cell and one squamous cell ( confirmed by biopsy's ) removed in doctors offices. Fast ,painless , convenient , not worth months of putting on salve to avoid. Nov 8, 2020 at 22:44
  • @blacksmith37 on the face? Mohs or excision? Nov 8, 2020 at 22:50
  • Arm, back of neck, forehead. All scalpel excisions. A few small things have been removed by freezing. Nov 9, 2020 at 17:22

1 Answer 1

1

The 2009 systematic review {1} summarized the success rate of the use of topical fluorouracil cream to treat a superficial basal cell carcinoma (BCC). It found only 1 study, which reported a 90% success rate (at 3-week follow-up, so an important remaining question is what the success rate is after a few years). See the first row of this table (Gross et al.) from {1}:

enter image description here


References:

  • {1} Love WE, Bernhard JD, Bordeaux JS. Topical imiquimod or fluorouracil therapy for basal and squamous cell carcinoma: a systematic review. Arch Dermatol. 2009;145(12):1431–8. https://doi.org/10.1001/archdermatol.2009.291

Your Answer

By clicking “Post Your Answer”, you agree to our terms of service and acknowledge that you have read and understand our privacy policy and code of conduct.

Not the answer you're looking for? Browse other questions tagged or ask your own question.