From the Guidelines
The primary treatment approach for squamous cell carcinoma (SCC) should be based on the tumor's stage, location, and patient's overall health, with early-stage tumors often treated with surgery or radiotherapy, and advanced tumors requiring a multidisciplinary approach including surgery, radiotherapy, and chemotherapy, as recommended by the ESMO clinical guidelines 1.
Key Considerations
- The treatment of SCC depends on the primary tumor location and extension, with early-stage tumors (I–II) having similar locoregional control with either surgery or radiotherapy 1.
- For advanced resectable tumors, standard options include surgery plus postoperative radiotherapy, and for those with high-risk features, postoperative chemoradiotherapy with single-agent platinum 1.
- A multidisciplinary treatment schedule should be established in all cases, including correction and maintenance of the patient's nutritional status and dental rehabilitation before radiotherapy 1.
Treatment Options
- Surgical removal is a standard treatment for early-stage SCC, with options including excisional surgery, Mohs micrographic surgery, curettage and electrodesiccation, or cryosurgery for very small lesions.
- Radiation therapy is an alternative when surgery isn't feasible or as adjuvant therapy following surgery for high-risk tumors.
- For advanced or metastatic SCC, a combination approach may be necessary, including systemic therapies such as immunotherapy, chemotherapy, or targeted therapy.
Follow-up Care
- Regular follow-up care is essential after treatment, with recommended regular skin examinations every 3-6 months for the first few years, as patients with one SCC have an increased risk of developing additional skin cancers.
From the Research
Treatment Approaches for Squamous Cell Carcinoma
The treatment approach for squamous cell carcinoma (SCC) can vary depending on the location, stage, and severity of the disease. Some studies have investigated the efficacy of different chemotherapy regimens and treatment modalities for SCC.
Chemotherapy Regimens
- A study published in 1990 2 found that a combination of cisplatin, 5-fluorouracil, and bleomycin was effective in treating advanced SCC of the skin, with an objective response rate of 84% and a complete remission rate of 30%.
- Another study published in 2017 3 investigated the efficacy of docetaxel, cisplatin, and 5-fluorouracil chemotherapy for superficial esophageal SCC and found a response rate of 60.7%.
- A study published in 1990 4 found that concomitant chemotherapy with cisplatin and 5-fluorouracil, along with split-course hyperfractionated radiation therapy, was effective in treating bulky SCC of the cervix, with a local pelvic response rate of 100% and a complete response rate of 66%.
Non-Surgical Treatment Modalities
- A study published in 1998 5 found that intratumoral chemotherapy with fluorouracil/epinephrine injectable gel was a effective nonsurgical treatment alternative for cutaneous SCC, with a histologically confirmed complete tumor clearing rate of 96%.
- A case report published in 2018 6 found that intralesional 5-fluorouracil was effective in treating lower leg SCC, highlighting the potential of this treatment modality for selected patients.
Key Findings
- Chemotherapy regimens such as cisplatin, 5-fluorouracil, and bleomycin, as well as docetaxel, cisplatin, and 5-fluorouracil, have shown efficacy in treating SCC.
- Non-surgical treatment modalities such as intratumoral chemotherapy with fluorouracil/epinephrine injectable gel and intralesional 5-fluorouracil may be effective alternatives for selected patients.
- The choice of treatment approach depends on the individual patient's disease characteristics, medical history, and preferences, and should be determined in consultation with a healthcare professional 2, 3, 4, 5, 6.