Im Kontakt mit ophthalmologischen Patient*innen sind Fragestellungen hinsichtlich
tumoröser Prozesse der Augenlider alltäglich. Meist handelt es sich um gutartige Läsionen,
deren Therapieoptionen übersichtlich und deren Prognose gut ist. Dennoch ist hierbei
stets
höchste Sorgfalt geboten, denn maligne Läsionen lassen sich teilweise schwer von benignen
unterscheiden. Ein Übersehen kann fatale Folgen für die Patient*innen bedeuten.
Abstract
Introduction Although surgical therapy is often the first-line treatment for
malignant eyelid tumors, pharmacological treatment approaches can also be included
and
pursued in the treatment plan.
Methods Narrative review with a selective literature search on PubMed and Google
Scholar.
Results Various pharmacological therapeutic principles are currently available.
One option is the local application of agents within the tumor area. This can be achieved
through cytostatically active drugs such as 5-fluorouracil for superficial basal cell
carcinomas and precursors of squamous cell carcinomas, or through mitomycin C in specific
cases of sebaceous gland carcinoma. Another form of pharmacological local therapy
is local
immunomodulation using Imiquimod for superficial basal cell carcinomas, actinic keratosis,
and Bowenʼs disease. Furthermore, there are systemic pharmacological therapies like
chemotherapies, for example in sebaceous cell carcinoma, or systemic immunomodulation
using checkpoint inhibitors for example in basal cell carcinoma, squamous cell carcinoma,
Merkel cell carcinoma, and melanoma. Additionally, targeted therapies offer yet another
treatment modality that exploits the molecular biological characteristics of various
tumor
entities. Examples of this include Hedgehog inhibitors for basal cell carcinomas,
EGFR
inhibitors for squamous cell carcinomas, or BRAF inhibitors for melanomas. This review
addresses these treatment options for malignant tumors of the eyelid and systematically
organizes them for the reader.
Conclusion Even though the data on these eye tumors is still limited, the reported
case studies using systemic therapies for malignant eyelid tumors demonstrate the
potential of this treatment modality. However, the need for further research is high
especially concerning the combination of different therapy principles for increasing
the
effectiveness of eyelid tumor therapy.
Schlüsselwörter
Hautkrebs - Augenlid - Systemtherapie - topische Therapie
Key words
Skin cancer - eyelid - systemic therapy - topical therapy
