Systemic treatment of basal cell carcinoma
Treatment with targeted drugs is indicated for patients in two cases:
1) With the development of basal cell metastases (an extremely rare condition, no more than 300 cases have been described in the literature).
2) With a pronounced local spread of the tumor, when it grows into the underlying tissues and surgery, radiation therapy is impossible or contraindicated.
The main drug for chemotherapy for basal cell carcinoma is Cisplatin. Its effectiveness has not been studied in prospective or randomized clinical trials, and therefore it varies very widely – from minimal changes in size to complete disappearance of the tumor.
The use of the drug in a very large percentage of cases is associated with pronounced side effects, such as toxic effects on the kidneys, nausea and vomiting, diarrhea, hair loss, joint pain, loss of balance, swelling, severe fatigue, ringing in the ears.
In connection with the above, it seems logical to use chemotherapy as a second line of treatment for basal cell carcinoma. This will be especially relevant for patients who do not have tumor regression or have developed resistance to targeted drugs.