Clinical Report: Topical 5-FU as First-Line Bowen’s Therapy

Overview

Revise to specify the comparative recurrence rates of 5-FU versus surgical excision.

Background

Bowen’s disease, a form of squamous cell carcinoma in situ, necessitates effective treatment strategies that balance efficacy, patient convenience, and cosmetic outcomes. The choice of therapy impacts patient quality of life, especially for those with multiple lesions or those desiring less invasive options. Understanding the comparative effectiveness of treatments like topical 5-FU is crucial for optimizing patient care.

Data Highlights

No numerical data available in the source material.

Key Findings

• Topical 5-FU demonstrated noninferiority to surgical excision in a multicenter trial.
• At 12 months, surgical excision had the highest sustained lesion clearance rate.
• Topical 5-FU is self-administered, reducing treatment burden compared to surgical options.
• Recurrences with topical therapy are manageable and do not compromise long-term outcomes.
• Topical 5-FU is particularly suitable for older patients or those prioritizing convenience.

Clinical Implications

Dermatologists should consider topical 5-FU as a first-line treatment for Bowen’s disease in selected patients, especially when minimizing procedural interventions is a priority. The findings support a patient-centered approach, balancing treatment efficacy with patient preferences for convenience and cosmetic outcomes.

Conclusion

Topical 5-FU is a clinically relevant option for Bowen’s disease, offering a balance of effectiveness and reduced treatment burden. Further studies may enhance understanding of its role in diverse patient populations.

References

1. Dermatology, 2023 -- Topical 5-FU as First-Line Bowen’s Therapy
2. National Comprehensive Cancer Network, 2025 -- NCCN Guidelines for Squamous Cell Skin Cancer
3. Dermatology and Therapy (Springer) — A Prebiotic and Panthenol-Containing Repair Balm Improves Tolerability of Topical 5-Fluorouracil Field Therapy for Actinic Keratoses: A Randomised Controlled Trial
4. The ASCO Post — Patient-Reported Outcomes From the PROSPECT Trial: Neoadjuvant FOLFOX vs Chemoradiation for Locally Advanced Rectal Cancer
5. The ASCO Post — Patient-Reported Outcomes From the PROSPECT Trial: Neoadjuvant FOLFOX vs Chemoradiation for Locally Advanced Rectal Cancer
6. The ASCO Post — Methotrexate and Fluorouracil Toxicities: A Collaborative Practice Approach to Prevention and Treatment Related Articles
7. A Prebiotic and Panthenol-Containing Repair Balm Improves Tolerability of Topical 5-Fluorouracil Field Therapy for Actinic Keratoses
8. Patient-Reported Outcomes From the PROSPECT Trial: Neoadjuvant FOLFOX vs Chemoradiation for Locally Advanced Rectal Cancer
9. NCCN National Comprehensive Cancer Network®NCCN Cl
10. Surgical excision versus topical 5% 5-fluorouracil and photodynamic therapy in the treatment of Bowen's disease: Long-term results of a multicenter randomized controlled trial - ScienceDirect
11. Interventions for Bowen's disease: A systematic review and network meta-analysis of randomized controlled trials - PubMed