Intralesional 5‐fluorouracil as a management for cutaneous squamous cell carcinomas: A rural Australian retrospective case series

Abstract

AbstractWhile the gold standard treatment for cutaneous squamous cell carcinomas (cSCCs) is surgical removal, there is a risk of infection, cosmetic and functional deficits. Intralesional 5‐fluorouracil (5‐FU) has been shown to be a potential non‐surgical treatment modality for cSCCs in the literature. The aim was to investigate the safety and feasibility of using intralesional 5‐FU to treat cSCCs. A literature review was conducted and a retrospective case series analysed patients who commenced intralesional 5‐FU treatment for at least one cSCC between 1 January 2018 and 1 January 2019 at a private clinic in Orange, Australia. Inclusion criteria include: at least one cSCC was treated; only intralesional 5‐FU was used; and treatment was ceased due to complete or inadequate remission, or adverse effects. There were 15 patients (7 female, 8 male, 60–99 years) and 20 out 21 cSCC lesions (82.6%) cleared while one lesion (4.3%) recurred. Six lesions (26.1%) ulcerated, four lesions became infected (17.4%) and one patient had an allergic reaction. The average number of treatments required for clearance was four (range 1–35), and the average 5‐FU dose used was 75 mg (range 50–150 mg). Across 25 studies, 656 out of 708 lesions cleared (92.66%). Adverse effects were self‐limiting and mostly well‐tolerated. Intralesional 5‐FU is an affordable and non‐invasive non‐surgical treatment modality that appears feasible to use for cSCCs and has a relatively low treatment‐associated morbidity. Future clinical trials can help develop a protocol to guide clinicians in its use.