Implication for clinical practice

Cryotherapy, although convenient and less expensive than radiotherapy, does not appear to have better cure rates than radiotherapy (especially for lesions >2 cm). Cosmetic effect

Table 26.2 Randomised controlled trials evaluating cryotherapy in the treatment of basal cell carcinoma

Study Method Participants Interventions Outcomes Notes

Table 26.2 Randomised controlled trials evaluating cryotherapy in the treatment of basal cell carcinoma

Study Method Participants Interventions Outcomes Notes

Hall et al.

Single centre

105 patients

T1: cryotherapy using

FU: Recurrence of

12 excluded:

198628 (UK)

Method of

BP BCCs T1: 44, T2:

a Cry-Owen liquid

tumour and cosmetic

5 died of other

randomisation not

49 patients

nitrogen spray gun; all

appearance at 1, 6,

causes, 7 lost to

known PP

Sites: T1: 30 neck and

lesions treated with

12, 24 months after

FU

face, 6 eyelids,

two freeze-thaw

treatment

Ex: recurrent

8 trunk. T2: 40 neck

cycles, freezing for

Tumour identified

tumours, lesions

and face, 3 eyelids,

1 minute each time,

histologically

on nose or pinna,

6 trunk

with a thaw time of at

lesion near eye

least 90 s

and vision in eye

T2: radiotherapy,

<6/18

(130 KVx rays)

Mallon and

Single centre

84 patients

T1: single 30-second

FU: T1: 10 months to

7 lost to FU,

Dawber, 199629

Method of

Mostly clinically

freeze-thaw cycle

7-1 years, T2: 1-2- 6-1

T1: 2, T2: 5

(UK)

randomisation not

proven BCCs

T2: double 30-second

years

known PP

Facial lesions <1-5 cm

freeze-thaw cycle

Lesions assessed

not extending >3 mm

clinically

below skin were

included. T1: 36, T2:

48 patients

Mean age T1: 67, T2:

69 years

Thissen et al.

Single centre.

103 patients

T1: surgery.

FU: cosmetic and

Lost to FU: 3 in

200030 (The

Method of

Some BP BCCs

T2: cryosurgery (no. 3

recurrence at 1 year

control group did

Netherlands)

randomisation not

Lesions S or N, <2 cm

currette used to

Recurrence assessed

not turn up for

known. PP

diameter, localised

debulk the tumour:

clinically

visits, 1 died

anywhere on the head

no. 1 used to remove

(unrelated to

and neck

remainder of BCC

treatment), 3

around the borders.

developed

Freezing: two freezing

recurrent BCC

periods, each lasting

(all T2)

20 seconds)

See Table 26.1 for abbreviations.

See Table 26.1 for abbreviations.

for radiotherapy and cryotherapy are comparable. Variations in technique occur between different physicians and may account for differences in outcome. Lesions bigger than 2 cm diameter treated by cryotherapy recurred, but lesions bigger than 2 cm and treated with radiotherapy were controlled. It was concluded that cryotherapy does not offer a satisfactory alternative to radiotherapy in the treatment of BCC.

0 0

Post a comment