索立德吉治疗基底细胞癌并文献复习  

Treatment of basal cell carcinoma with Sonidegib and literature review

作　　者：贾子悦 庄哲 李欣辉 陈永锋 JIA Ziyue;ZHUANG Zhe;LI Xinhui;CHEN Yongfeng(Dermatology Hospital,Southern Medical University,Guangzhou 510091,China)

机构地区：[1]南方医科大学皮肤病医院,广东广州510091

出　　处：《皮肤性病诊疗学杂志》2024年第7期484-488,共5页Journal of Diagnosis and Therapy on Dermato-venereology

摘　　要：目的 探讨索立德吉对基底细胞癌的疗效及不良反应。方法 对1例以鼻背褐色斑块伴糜烂破溃的患者进行临床资料分析及组织病理检查,确诊后使用Hedgehog通路抑制剂——索立德吉进行减瘤治疗。结果 患者诊断为基底细胞癌,经索立德吉治疗后皮损较前好转,皮损平坦,糜烂、溃疡愈合结痂,无新发破溃。服药前患者无肝酶及肌酶异常,但服药1周后患者出现了肌肉无力、食欲下降、呕吐、乏力、嗜睡等不适症状,EGOG达到3级;第4周时患者的肝酶及血清CK均升高至正常上限的2.5倍以上;第6周时患者因不能耐受不良反应而中断服药。后续患者接受Mohs切除后植皮术治疗。结论 索立德吉的肝脏损伤、肌肉骨骼不良反应明显。临床应用时必须动态监测患者不良反应相关指标。对于肿瘤面积较大、直接手术创伤大的患者,在术前给予新辅助治疗帮助减瘤是有效且有益的,应用时可根据患者耐受情况进行间隔用药等方法提高耐受坚持治疗。Objective To investigate the efficacy and safety of Sonidegib for basal cell carcinoma.Methods Clinical data and skin histology were analyzed in a patient with ulcerated brown plaque on the nasal dorsum.After the diagnosis of basal cell carcinoma,patient was orally given a Hedgehog pathway inhibitor,Sonidegib.Results The patient was diagnosed with basal cell carcinoma.After the treatment with Sonidegib,the skin lesions became flat and ulcers were healed,without the development of new ulcers.Prior to the treatment,patient′s liver and muscle enzymes were normal.Following one-week treatment with Sonidegib,the patient experienced muscle weakness,loss of appetite,vomiting,fatigue,and drowsiness,with an EGOG level of 3.After 4 weeks of treatment,the liver enzymes and serum CK were 2.5 times over normal levels.Sonidegib was discontinued at week 6 due to his intolerance of side effects.Then the patient was given the Mohs surgery and skin grafting.Conclusions Sonidegib can induce liver damage and musculoskeletal reactions.Adverse reactions should be dynamically monitored in clinical use of this drug.If the tumor is large or direct surgical removal may cause severe trauma,neoadjuvant therapy can be beneficial.In clinic,drugs can be intermittently administered according to patients′tolerance to improve tolerance and adherence.

关 键 词：基底细胞癌 索立德吉 Hedgehog通路抑制剂 

分 类 号：R739.5[医药卫生—肿瘤]