Abstract
Immunocryosurgery is a minimally invasive combinational therapeutic procedure that has been designed, developed, and evaluated in the Dermatology Department of the University of Ioannina from 2004. In a fixed time protocol, this approach combines immune stimulatory therapy with imiquimod and cryosurgery, i.e., cryosurgery is applied during continuous imiquimod treatment. Laboratory findings in tissue and blood level credit the efficacy to the synergy of imiquimod and cryosurgery. The synergy has been established through clinical trials and the excellent feasibility and efficacy demonstrated in clinical practice. Immunocryosurgery has extensive proof of excellent efficacy, comparable to surgery, in the treatment of basal cell carcinoma. It has also been evaluated in cases of Bowen’s disease, keratoacanthoma, Merkel cell carcinoma, lentigo maligna, and cutaneous squamous cell carcinoma with or without the addition of adjuvants. The aims of this review are to detail the immunocryosurgery protocol with the addition of daily practice clinical tips, compile data on the mechanism of action of immunocryosurgery, and delineate indications and possible future applications. Most of the available data originate from the treatment of BCC, of all histological types and localizations, and the principles reported mainly reflect on evidence related to the treatment of this common skin cancer.
Highlights
Immunocryosurgery is a minimally invasive combinational therapeutic procedure that has been designed, developed, and evaluated in the Department of Dermatology in the University of Ioannina Medical School from 2004 [1]
Actinic cheilitis can progress to highly invasive squamous cell carcinoma of the lower lip [44]; for this reason, we have evaluated the typical 5-week immunocryosurgery protocol for this condition in eight patients [45]
By transferring our experience from large basal cell carcinoma (BCC) [26,33] and cutaneous squamous cell carcinoma (cSCC) cases [10], we know that the immunocryosurgery can be potentiated with repeated sessions of cryosurgery while the tumor is under continuous topical imiquimod treatment
Summary
During the development period, immunocryosurgery was designed based on general principles of cancer immunotherapy and the theoretical implementation of published data on the anticancer modes of action of the two combined modalities [2]. The aims of this review are to detail the immunocryosurgery protocol with the addition of practical tips for its successful application in the every-day clinical practice, compile data on the mechanism of action, and to delineate indications and possible future. Originate from the treatment protocol of BCC, with of allthe histooftypes practical for its successful application in the every-day clinical practice, logical andtips localizations, and the general principles reported mainlycompile reflect data on the mechanism of action, and indications and possible future applications. Most of the available data originate from the treatment of BCC, of all histological types and localizations, andofthe general principles reported mainly reflect on evidence and
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