قد يستلزم تحقيق الإزالة الكاملة لآفات التقران السفعي اتباع نهج مركب بدلاً من الاعتماد على طريقة علاجية واحدة فحسب. يُحدد هذا البروتوكول استراتيجية تجمع بين العلاج الموضعي والتدخل الإجرائي لتحقيق أقصى استجابة علاجية ممكنة.
A randomized study compared a 1-week pretreatment course of 0.5% 5-FU cream with cryosurgery to the use of vehicle cream before cryosurgery.
Based on this moderate quality evidence suggesting enhanced lesion reduction without increased adverse events, combined 5-FU cream and cryosurgery is conditionally recommended over cryosurgery alone.
Studies have compared the use of imiquimod in 3.75% or 5% concentrations following cryosurgery to cryosurgery with subsequent application of a vehicle.
Thus, the intervention is conditionally recommended over cryosurgery alone, based on this low quality evidence.
At 22 weeks post treatment, rates of complete clearance were 22.6% in participants treated with a combination of 5% imiquimod and cryosurgery and 9.4% in participants treated with a vehicle cream and cryosurgery (RR, 2.41; 95% CI, 0.68-8.48; P = .17).
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