{"title":"眼眶周围皮肤鳞状细胞癌的全身新辅助治疗。","authors":"Jiawei Zhao, Bita Esmaeli","doi":"10.1097/IIO.0000000000000454","DOIUrl":null,"url":null,"abstract":"Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer after basal cell carcinoma.1 cSCC accounts for 5% to 10% of all eyelid cancers with an incidence rate estimated to be 1.37 per 100,000 individuals per year.2–4 Majority of patients with periorbital cSCC are older (60 years of age or older) and fair-skinned with significant sun exposure.3,5–7 Locally advanced cSCC in the periorbital region, when treated with current standard of care which is surgery followed by adjuvant radiotherapy (with or without concurrent chemotherapy) can lead to significant morbidity with poor cosmetic and functional outcome. An attempt for R0 resection (microscopically margin-negative resection) in such patients can be extensive, causing loss of lacrimal drainage apparatus and a significant distortion of the eyelid and orbit despite best efforts in reconstruction. Orbital exenteration is often required in locally advanced periorbital cases of cSCC. Orbital exenteration causes major functional impairment and aesthetic deformity, and is associated with substantial negative emotional and psychosocial impact.8–10 Highdose radiation therapy in the periorbital region is also associated with significant ocular toxicity, including dry eye syndrome, keratopathy, cataract, optic neuropathy, and radiation-induced retinopathy.11 Despite aggressive local treatments, the recurrence rate for locally advanced resectable cSCC of the head and neck region is up to 30% and can progress to death from disease in some patients.12,13 The 2-year diseasefree survival in locally advanced, resectable cSCC treated by current standard of care (surgery and adjuvant radiation) has been reported to be 78%.14","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"35-46"},"PeriodicalIF":0.0000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Systemic Neoadjuvant Therapies for Treatment of Cutaneous Squamous Cell Carcinoma of the Periorbital Region.\",\"authors\":\"Jiawei Zhao, Bita Esmaeli\",\"doi\":\"10.1097/IIO.0000000000000454\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer after basal cell carcinoma.1 cSCC accounts for 5% to 10% of all eyelid cancers with an incidence rate estimated to be 1.37 per 100,000 individuals per year.2–4 Majority of patients with periorbital cSCC are older (60 years of age or older) and fair-skinned with significant sun exposure.3,5–7 Locally advanced cSCC in the periorbital region, when treated with current standard of care which is surgery followed by adjuvant radiotherapy (with or without concurrent chemotherapy) can lead to significant morbidity with poor cosmetic and functional outcome. An attempt for R0 resection (microscopically margin-negative resection) in such patients can be extensive, causing loss of lacrimal drainage apparatus and a significant distortion of the eyelid and orbit despite best efforts in reconstruction. Orbital exenteration is often required in locally advanced periorbital cases of cSCC. Orbital exenteration causes major functional impairment and aesthetic deformity, and is associated with substantial negative emotional and psychosocial impact.8–10 Highdose radiation therapy in the periorbital region is also associated with significant ocular toxicity, including dry eye syndrome, keratopathy, cataract, optic neuropathy, and radiation-induced retinopathy.11 Despite aggressive local treatments, the recurrence rate for locally advanced resectable cSCC of the head and neck region is up to 30% and can progress to death from disease in some patients.12,13 The 2-year diseasefree survival in locally advanced, resectable cSCC treated by current standard of care (surgery and adjuvant radiation) has been reported to be 78%.14\",\"PeriodicalId\":14338,\"journal\":{\"name\":\"International Ophthalmology Clinics\",\"volume\":\"63 3\",\"pages\":\"35-46\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Ophthalmology Clinics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/IIO.0000000000000454\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Ophthalmology Clinics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/IIO.0000000000000454","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Systemic Neoadjuvant Therapies for Treatment of Cutaneous Squamous Cell Carcinoma of the Periorbital Region.
Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer after basal cell carcinoma.1 cSCC accounts for 5% to 10% of all eyelid cancers with an incidence rate estimated to be 1.37 per 100,000 individuals per year.2–4 Majority of patients with periorbital cSCC are older (60 years of age or older) and fair-skinned with significant sun exposure.3,5–7 Locally advanced cSCC in the periorbital region, when treated with current standard of care which is surgery followed by adjuvant radiotherapy (with or without concurrent chemotherapy) can lead to significant morbidity with poor cosmetic and functional outcome. An attempt for R0 resection (microscopically margin-negative resection) in such patients can be extensive, causing loss of lacrimal drainage apparatus and a significant distortion of the eyelid and orbit despite best efforts in reconstruction. Orbital exenteration is often required in locally advanced periorbital cases of cSCC. Orbital exenteration causes major functional impairment and aesthetic deformity, and is associated with substantial negative emotional and psychosocial impact.8–10 Highdose radiation therapy in the periorbital region is also associated with significant ocular toxicity, including dry eye syndrome, keratopathy, cataract, optic neuropathy, and radiation-induced retinopathy.11 Despite aggressive local treatments, the recurrence rate for locally advanced resectable cSCC of the head and neck region is up to 30% and can progress to death from disease in some patients.12,13 The 2-year diseasefree survival in locally advanced, resectable cSCC treated by current standard of care (surgery and adjuvant radiation) has been reported to be 78%.14
期刊介绍:
International Ophthalmology Clinics is a valuable resource for any medical professional seeking to stay informed and up-to-date regarding developments in this dynamic specialty. Each issue of this quarterly publication presents a comprehensive review of a single topic in a new or changing area of ophthalmology. The timely, tightly focused review articles found in this publication give ophthalmologists the opportunity to benefit from the knowledge of leading experts in this rapidly changing field.