CUTANEOUS SQUAMOUS-CELL CARCINOMA IN PATIENTS TREATED WITH PUVA
CUTANEOUS SQUAMOUS-CELL CARCINOMA IN PATIENTS TREATED WITH PUVA
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DOI：
10.1056/nejm198405033101805
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发表时间：
1984-01-01
影响因子：
158.5
通讯作者：
BLEICH, HL
中科院分区：
文献类型：
--
作者：
STERN, RS;LAIRD, N;BLEICH, HL
一项对1380名使用口服甲氧沙林(8-甲氧补骨脂素)和紫外线A光化疗(PUVA)治疗银屑病患者的5.7年前瞻性研究显示，在调整了对电离辐射和局部焦油制剂的暴露后，皮肤鳞状细胞癌发展至少22个月的风险。在第一次接触PUVA后，高剂量暴露的患者比低剂量暴露的患者高12.8倍(95%可信区间，5.8-28.5)。对于基底细胞癌，没有发现与剂量相关的实质性增加。皮肤鳞状细胞癌的剂量依赖性风险表明，PUVA可以作为一种独立的致癌物。与这些肿瘤相关的发病率是有限的，但需要进一步的随访。同时，应密切跟踪接受PUVA治疗的患者是否有可能发展为皮肤鳞状细胞癌。
A 5.7-yr prospective study of 1380 patients treated for psoriasis with oral methoxsalen (8-methoxypsoralen) and UV A photochemotherapy (PUVA) revealed that after adjustment for exposures to ionizing radiation and topical tar preparations, the risk that cutaneous squamous-cell carcinoma would develop at least 22 mo. after the 1st exposure to PUVA was 12.8 times higher in patients exposed to a high dose than in those exposed to a low dose (95% confidence interval, 5.8-28.5). No substantial dose-related increase was noted for basal-cell carcinoma. The dose-dependent risk of cutaneous squamous-cell carcinoma suggests that PUVA can act as an independent carcinogen. Morbidity associated with these tumors was limited, but further follow-up is needed. Meanwhile, patients treated with PUVA should be followed closely for the possible development of cutaneous squamous-cell carcinoma.