Comparative Analysis of US Guidelines for the Management of Cutaneous Squamous Cell and Basal Cell Carcinoma

Table 5

Management of primary tumor with curative intent: nonsurgical treatments.

Treatment	AAD			NCCN		ASTRO
	Narrative	LOE	SOR	Narrative	COE	Narrative	QOE	SOR
SCC						Beyond the scope of ASTRO guidelines
Imiquimod	Not recommended	III	C	Not recommended
5-Fluorouracil	Not recommended	III	C	Not recommended
Photodynamic therapy	Not recommended	II	B	Not recommended
Laser therapy	Not recommended	III	C	Not recommended
Cryosurgery	Only for low-risk tumors where other effective treatments are contraindicated	II	B	Not recommended
BCC
Imiquimod	Reserved for low-risk tumors where other definitive treatments are contraindicated	I	A	Not routinely recommended but consider for low-risk BCC where other more effective treatments are contraindicated
5-Fluorouracil		I, II	B
Photodynamic therapy		I, II	A
Cryosurgery		I	A

AAD: American Academy of Dermatology (Reference #[9, 11]), NCCN: National Comprehensive Cancer Network (Reference #[13]), ASTRO: American Society of Radiation Oncology (Reference #[12]), LOE: level of evidence, QOE: quality of evidence, SOR: strength of recommendation, and COE: category of evidence.