Electrochemotherapy of basal cell carcinoma

Abstract

Basal Cell Carcinoma (BCC) represents an evolving clinical challenge. It is the most common form of skin cancer and is increasing in prevalence due to aging populations and greater recreational sun exposure. As a result, it is responsible for a growing burden on healthcare services and requires a range of treatment options. The current gold standard for treatment of BCC is surgical excision. Other treatment options include topical chemotherapeutic agents, for example, Imiquimod or 5-fluorouracil; cryotherapy, typically with liquid nitrogen; photodynamic therapy; and others. Electrochemotherapy (ECT) offers the potential to successfully treat BCCs in patients who would be unsuitable for conventional treatments, either due to patient comorbidities, patient preference or the risk of cosmetic or functional impairment. This is particularly relevant in BCC as it predominantly affects aesthetically important, sun exposed areas, for example, the nose, face, and ears. It is also useful in those patients who have a greater burden of disease, for example, in Gorlin syndrome, in order to avoid extensive, disfiguring surgical excisions, or as neo-adjuvant treatment to reduce the extent of surgical excision required. Systematic reviews have confirmed its utility in this regard. In future, ECT may be offered more widely as a first-line treatment due to its reduced sequelae when compared to other techniques.