Abstract
Background: Non-melanoma skin cancer can cause considerable morbidity when located on the eyelids and periocular skin. Basal cell carcinoma is the commonest periocular malignancy and although metastases are extremely rare, local invasion can cause significant and sometimes severe morbidity. Interferons may provide a nonsurgical approach to the management of these tumors. The aim of this work was to evaluate retrospectively, the effect of a formulation containing IFNs alpha2b and gamma in synergistic proportions (HeberPAG) on patients with periocular NMSC. Methods: The patients were identified from the data base from Department of Peripheral Tumors at “National Institute of Oncology and Radiobiology” in Havana; Dermatological Department at “Hermanos Ameijeiras” and “Enrique Cabrera” Hospitals; and policlinics from rural zone in Mayabeque; Cuba. The applications of IFN combination were practiced by medical doctors specialized in dermato-oncology. The employed doses for IFN combination were from 0.875 × 106 IU to 27 × 106 IU. Results: The series include 18 basal cell carcinoma and 3 squamous cell carcinoma of the skin with predominant clinical forms mixed (33.3%) and nodular (38.1%), 3 cases were terebrant, 2 ulcerated and 1 pigmented. The median time of tumor evolution was 16.5 months with an initial diameter of 8.25 cm. At week 12 after the end of treatment, a 47.6% complete response rate was obtained. A partial response was achieved in 5 patients (23.8%). A high response rate was obtained with overall response (CR+PR) in 71.4%. All patients reported at least 1 adverse event. The most frequent (>20%) were fever, chills, anorexia, cephalea, perilesional erythema and edema, asthenia, arthralgia and general discomfort. Conclusions: HeberPAG is an alternative useful to surgery in patients with periocular non-melanoma skin cancer when other therapies have failed or are not possible. The encouraging result justifies further confirmatory trials in periocular region.
Highlights
Non-melanoma skin cancer can cause considerable morbidity when located on the eyelids and periocular skin
Due to the clearance rates being lower than for surgical treatments, photodynamic therapy (PDT) is not generally recommended for management of nodular basal cell carcinoma (BCC) on the head or neck
While primary superficial BCCs on the face may be amenable to treatment is not recommended for recurrent disease [19]
Summary
Non-melanoma skin cancer can cause considerable morbidity when located on the eyelids and periocular skin. Basal cell carcinoma is the commonest periocular malignancy and metastases are extremely rare, local invasion can cause significant and sometimes severe morbidity. The most common form of skin cancer is basal cell carcinoma (BCC), accounting for 80-90% of skin malignancies [1,2]. BCC is the commonest periocular malignancy and metastases are extremely rare, local invasion can cause significant and sometimes severe morbidity [3,4]. BCC can cause considerable morbidity when located on the eyelids (80-95%). The tumor arises most commonly in the lower eyelid (50-72 %), followed by the medial canthus (9.6-27.6%), the upper eyelid, and the lateral canthus [5]. The remaining anatomical location and the incidence of occurrence differ from author to author
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