Cutaneous squamous cell carcinoma (cSCC) is the second most common skin malignancy and poses a significant risk to immunosuppressed patients, such as solid organ transplant recipients and those with hematopoietic malignancies, who are up to 100 times more likely to develop cSCC compared with the general population. This review summarizes the current state of treatment for cSCC in immunosuppressed patients, focusing on prevention, prophylaxis, surgical and non-surgical treatments, and emerging therapies. Preventative measures, including high-SPF sunscreen and prophylactic retinoids, are crucial for reducing cSCC incidence in these patients. Adjusting immunosuppressive regimens, particularly favoring mTOR inhibitors over calcineurin inhibitors, has been shown to lower cSCC risk. Surgical excision and Mohs micrographic surgery remain the primary treatments, with adjuvant radiation therapy recommended for high-risk cases. Traditional chemotherapy and targeted therapies like EGFR inhibitors have been utilized, though their efficacy varies. Immunotherapy, particularly with agents like cemiplimab and pembrolizumab, has shown promise, but its use in immunosuppressed patients requires further investigation due to potential risks of organ rejection and exacerbation of underlying conditions. Treatment of cSCC in immunosuppressed patients is multifaceted, involving preventive strategies, tailored surgical approaches, and cautious use of systemic therapies. While immunotherapy has emerged as a promising option, its application in immunosuppressed populations necessitates further research to optimize safety and efficacy. Future studies should focus on the integration of personalized medicine and combination therapies to improve outcomes for this vulnerable patient group.
皮肤鳞状细胞癌（cSCC）是第二常见的皮肤恶性肿瘤，对免疫抑制患者（如实体器官移植受者和造血系统恶性肿瘤患者）构成显著风险，其患病概率可比普通人群高出100倍。本综述总结了当前免疫抑制患者cSCC的治疗现状，重点关注预防措施、手术与非手术治疗以及新兴疗法。预防性措施（包括高防晒指数防晒霜和预防性维甲酸类药物）对降低此类患者cSCC发病率至关重要。调整免疫抑制方案（特别是优先选用mTOR抑制剂而非钙调神经磷酸酶抑制剂）已被证实可降低cSCC风险。手术切除和莫氏显微外科手术仍是主要治疗手段，高危病例建议辅以放射治疗。传统化疗及靶向治疗（如EGFR抑制剂）已有应用，但其疗效存在差异。免疫疗法（尤其是西米普利单抗和帕博利珠单抗等药物）显示出良好前景，但由于存在器官排斥和基础疾病恶化的潜在风险，其在免疫抑制患者中的应用仍需进一步研究。免疫抑制患者cSCC的治疗具有多维度特点，需结合预防策略、个体化手术方案及谨慎的系统性治疗。尽管免疫疗法已成为一种有前景的选择，但其在免疫抑制人群中的应用仍需进一步研究以优化安全性和疗效。未来研究应聚焦于个体化医疗与联合疗法的整合，以改善这一脆弱患者群体的预后。
肿瘤(癌症)患者之家