What is the role of 5-florouracil (5-FU), and diclofenac sodium gel in the treatment of cutaneous squamous cell carcinoma (cSCC)?

Updated: Jul 08, 2020
  • Author: Talib Najjar, DMD, MDS, PhD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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A full course of 5-FU therapy is twice-daily administration for 4 weeks. However, even if the newer, low-concentration 5-FU cream is used (0.5% vs previously available 5% concentration), significant discomfort and irritation are inevitable, and residual erythema at the site of application may persist for months. Patients who cannot tolerate this duration may try shorter courses and then resume treatment after a healing phase. Subsequent treatments become more tolerable as the epidermal damage is corrected.

An oral form of a 5-FU prodrug (capecitabine), which is approved by the US Food and Drug Administration (FDA) for other forms of cancer, may be considered in patients with diffuse SCCIS over large skin areas on which topical 5-FU is difficult to apply. However, studies of efficacy have not yet been performed.

Topical diclofenac sodium gel has been approved for the treatment of actinic keratoses. Twice-daily applications for 60-90 days may similarly clear actinic damage, with the longer course potentially offset by a lesser degree of cutaneous irritation.

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