Oral psoralen and ultraviolet-A light (PUVA) treatment of psoriasis and persistent risk of nonmelanoma skin cancer
Oral psoralen and ultraviolet-A light (PUVA) treatment of psoriasis and persistent risk of nonmelanoma skin cancer
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DOI：
10.1093/jnci/90.17.1278
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发表时间：
1998-09-02
影响因子：
10.3
通讯作者：
Väkevä, L
中科院分区：
文献类型：
--
作者：
Stern, RS;Liebman, EJ;Väkevä, L
背景/方法：大剂量口服补骨脂素和紫外线A光(即PUVA)治疗银屑病会显著增加皮肤鳞状细胞癌的风险，但不会增加基底细胞癌的风险。在开始治疗的十年内，为了评估接受PUVA治疗的个体的癌症风险的持久性，包括那些很久以前停止治疗的人和那些没有大量接触其他致癌物的人，我们前瞻性地研究了1975年1月1日至1976年10月1日期间首次治疗的1380名银屑病患者，并评估了与1985年后皮肤鳞状细胞癌和基底细胞癌发展相关的危险因素。结果：从1975年到1996年，237名患者发生了1422例皮肤鳞状细胞癌。从1986年到1996年，在1081名没有鳞状细胞癌病史的患者中，135人(12.5%)发生了593例此类肿瘤。从1975年到1997年，247名患者发生了1042例基底细胞癌；这些患者包括151名1985年后首次发生基底细胞癌的患者，在前瞻性研究的第一个十年中，没有鳞状细胞癌或基底细胞癌的患者中，在接下来的十年中观察到了与剂量相关的鳞状细胞癌风险的显著增加(调整后的相对风险[大于或等于337次治疗与
Background/Methods: The treatment of psoriasis with high-dose exposure to oral psoralen and ultraviolet-A light (i.e., PUVA) substantially increases the risk of cutaneous squamous cell cancer, but not of basal cell cancer, within a decade of beginning treatment, To assess the persistence of cancer risk among individuals treated with PUVA, including those who discontinued therapy long ago and those without substantial exposure to other carcinogens, we prospectively studied a cohort of 1380 patients with psoriasis who were first treated during the period from January 1, 1975, through October 1, 1976, and evaluated risk factors associated with the development of cutaneous squamous cell cancers and basal cell cancers after 1985, Results: From 1975 through 1996, 237 patients developed 1422 cutaneous squamous cell cancers. From 1986 through 1996, 135 (12.5%) of 1081 patients without a prior squamous cell cancer developed 593 such tumors. From 1975 through 1997, 247 patients developed 1042 basal sell cancers; these patients included 151 individuals with a first basal cell cancer after 1985, Among those without a squamous cell or a basal cell cancer in the first decade of the prospective study, a strong dose-related increase in the risk of squamous cell cancer was observed in the subsequent decade (adjusted relative risk [greater than or equal to 337 treatments versus