PUVA AND SKIN-CANCER - A HISTORICAL COHORT STUDY ON 492 PATIENTS
PUVA AND SKIN-CANCER - A HISTORICAL COHORT STUDY ON 492 PATIENTS
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DOI：
10.1016/0190-9622(92)70021-7
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发表时间：
1992-02-01
影响因子：
13.8
通讯作者：
CRIPPS, DJ
中科院分区：
文献类型：
--
作者：
CHUANG, TY;HEINRICH, LA;CRIPPS, DJ
背景：补骨脂素加紫外线 A (PUVA) 光疗的安全性一直是一个有争议的问题。 一些多中心合作研究报告称，接受 PUVA 治疗的患者中基底细胞癌和鳞状细胞癌的发病率有所增加。 自1975年以来，我们研究所已有超过1000名患者接受了PUVA治疗。 目的：我们调查接受高剂量PUVA的患者皮肤癌的发病率是否有所增加。 方法：这是对两组患者进行历史队列研究。 研究对象是 492 名在 1975 年至 1989 年间接受 PUVA 治疗的银屑病患者。一组 103 名患者；定义为高剂量组，接受累积PUVA剂量1000焦耳/cm2或以上；另一组 389 名患者作为低剂量组，接受 200 焦耳/cm2 或更少的能量。 分析两个比较组中皮肤癌的发生情况。结果：在高剂量组中，我们观察到鳞状细胞癌、角化棘皮瘤和光化性角化病患者数量增加。 我们没有看到任何患有生殖器癌、黑色素瘤的患者，也没有发现基底细胞癌患者数量增加。结论：接受高剂量 PUVA 的患者发生鳞状细胞癌的风险得到证实。 我们推测包括 PUVA 在内的多种因素可能会导致这种风险。
Background: The safety of psoralen plus ultraviolet A (PUVA) light therapy has been an issue of debate. A few multiple-center cooperative studies have reported an increase of basal cell and squamous cell carcinomas among PUVA-treated patients. In our institute, more than 1000 patients have been treated with PUVA since 1975.Objective: We investigated the incidence of skin cancer among patients who received high doses of PUVA to see whether such incidence increased.Methods: This is a historical cohort study of two comparison groups of patients. Subjects under study were 492 psoriasis patients who received PUVA treatments between 1975 and 1989. One group of 103 patients; defined as the high-dose group, received an accumulated PUVA dose of 1000 joules/cm2 or more; another group of 389 patients, as the low-dose group, received 200 joules/cm2 or less. The occurrence of skin cancer in the two comparison groups is analyzed.Results: In the high-dose group we observed an increased number of patients with squamous cell carcinoma, keratoacanthoma, and actinic keratosis. We did not see any patients with genital cancer, melanoma, or an increased number of patients with basal cell carcinoma.Conclusion: The risk of squamous cell carcinoma developing in patients who received a high dose of PUVA is confirmed. We speculate a combination of factors, including PUVA, may contribute to this risk.