Non-Melanoma Skin Cancers Coverage from Every Angle

Is Intralesional Fluorouracil Effective in Treatment of Cutaneous Squamous Cell Carcinoma?

By: Kayci Reyer
Posted: Thursday, April 1, 2021

According to research presented in the Journal of the American Academy of Dermatology, intralesional fluorouracil (5-FU) may be an effective treatment option for select patients with cutaneous squamous cell carcinoma. The therapy appears to be efficacious, minimally invasive, and cost-effective.

“To our knowledge, this is the largest study to date to evaluate the efficacy of intralesional 5-FU in the treatment of [squamous cell carcinoma],” noted James Appel, MD, of Campbell University, Wilmington, North Carolina, and colleagues.

The retrospective cohort study included 148 patients, 93 of whom were men (63%), who had received intralesional 5-FU between January 1, 2010, and April 1, 2019. Patients received a 50-mg/mL concentration of intradermal 5-FU at volumes ranging from 0.2 mL to 2 mL per lesion. Across all patients, 172 squamous cell carcinomas were identified, with 165 classified as an invasive disease and 7 identified as a keratoacanthoma subtype. Almost all (n = 170) of the lesions had a diameter of less than 2 cm. Treated lesions were most commonly located on a lower extremity (37%).

The most common follow-up time was at 4 weeks, at which point any lesions still present but showing clinical response received consideration for repeat injections. Lesions showing no response were considered for repeat injections or surgical intervention. Following treatment, 158 lesions (92%) were clinically resolved, 24% of which required at least a single repeat injection. From this cohort, one lesion underwent surgical treatment for a recurrence of keratoacanthoma. A total of five patients experienced adverse events, with most being local injection-site reactions, though one patient experienced headache, dizziness, and nausea.

Disclosure: The study authors reported no conflicts of interest.

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