MODERN AND PROSPECTIVE APPROACHES TO THERAPY OF INOPERABLE BASAL-CELL AND METATYPICAL CUTANEOUS CANCER

There are no universal approaches to and adequate method for pathogenetic therapy of neglected inoperable forms of basal-cell and metatypical cutaneous cancer. Moreover, there are no specialists at primary health care centers, capable to monitor the therapy of patients with these conditions. This paper analyzes the therapeutic strategy of physicians — dermatologists, dermato-oncologists, and oncologists in clinical morphological variants of basal-cell cutaneous cancer (BCC). The difficulties in the diagnosis of this condition and choice of adequate therapeutic strategy of skin tumors, characterized by a great variety of clinical forms and histological types, are explained, in addition to the objective causes (pathomorphsis, late application of patients, etc.), by the absence of conditions for the early diagnosis of epithelial tumors of the skin. This leads to increase in the incidence of neglected metastatic variants of the disease. Therapeutic methods, relapse risks, and criteria for the choice of therapeutic strategies are analyzed by the data presented in Cochrane Collaboration, 2007. Some aspects of the new promising approach to therapy of inoperable BCC and metatypical cutaneous cancer are presented, based on blocking one of the molecular mechanisms of tumor development — the hedgehog signal pathway, its inhibitors blocking the key pathogenetic pathway of BCC development.

basal-cell cutaneous cancer, metatypical cutaneous cancer, inoperable neglected forms, therapeutic methods, relapse risks, hedgehog signal pathway inhibitors