Topical Combination of Fluorouracil and Calcipotriene as a Palliative Therapy for Refractory Extramammary Paget Disease
| Autor: | Saami Khalifian, Gabriel E. Molina, Kenneth H. Ngo, Jamie L. Mull, Beverly E. Faulkner-Jones, Shadmehr Demehri, Lu Chen, Peggy A. Wu, Ilana S. Rosman, Lynn A. Cornelius |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Palliative care Skin Neoplasms Administration Topical Imiquimod Dermatology 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Refractory Calcitriol Antineoplastic Combined Chemotherapy Protocols Medicine Humans Adverse effect Aged Retrospective Studies business.industry Brief Report Palliative Care Retrospective cohort study Middle Aged medicine.disease Paget Disease Extramammary Treatment Outcome Fluorouracil 030220 oncology & carcinogenesis Calcipotriene Adenocarcinoma Female business medicine.drug |
| Popis: | Importance Extramammary Paget disease (EMPD), a rare intraepithelial adenocarcinoma, poses a therapeutic challenge with high postoperative recurrence rates and a limited number of effective local treatment options. Objective To describe the use and efficacy of a topical combination of fluorouracil and calcipotriene as a palliative therapy for refractory EMPD. Design, Setting, and Participants This retrospective case series of 3 women with recurrent, refractory EMPD was conducted at Beth Israel Deaconess Medical Center, Boston, Massachusetts and Washington University School of Medicine, St Louis, Missouri. All patients were treated with a 1:1 mixture of fluorouracil, 5%, cream and calcipotriene, 0.005%, cream or ointment. Main Outcomes and Measures Clinical and histopathological findings. Results All 3 women (1 in her 50s, 2 in their 70s) presented with recurrent EMPD (vulvar, perianal, and perioral) after surgery and/or irradiation, and their EMPD was refractory to treatment with imiquimod, 5%, cream. Owing to disease progression and/or intolerable adverse effects from imiquimod, the patients began treatment with a 1:1 mixture of fluorouracil, 5%, cream and calcipotriene, 0.005%, cream. This treatment, which was well tolerated, was followed by clinical improvement in symptoms and appearance of the lesions in all 3 cases and histopathological signs of decreased tumor burden in 2 cases. Patients applied the combination topical therapy to affected areas with differing frequencies, ranging from 1 to 2 days per month to 4 consecutive days every 2 weeks. Conclusions and Relevance Extramammary Paget disease frequently recurs even after aggressive surgical management and can be refractory to many topical and locoregional therapies. Palliative treatment with a combination of fluorouracil and calcipotriene may be a viable option for patients with recurrent, refractory EMPD. |
| Databáze: | OpenAIRE |
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