Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2024
Efficacy and safety of topical 0.5% 5-Fluorouracil as primary treatment of ocular surface squamous neoplasia.
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Kato Juliana Mika, Ballalai Priscilla Luppi, de Lima Patricia Picciarelli, Santo Ruth Miyuki
Аннотация
OBJECTIVE: To assess the efficacy and safety of topical 0.5% 5-Fluorouracil (5-FU) as a primary therapy of ocular surface squamous neoplasia (OSSN).
DESIGN: Retrospective study.
PARTICIPANTS: Patients with clinically suspected OSSN referred to a Brazilian tertiary health center between October 2015 and December 2022.
METHODS: After diagnostic confirmation of OSSN with exfoliative cytology, 0.5% 5-FU was administered topically 4 times daily for 2 weeks followed by a pause of 2 weeks.
RESULTS: A total of 54 patients were included in this study, 32 males (59.3%), mean age of 62.9 years old. Complete resolution of OSSN was achieved in 70.4%. The median number of cycles was 2 (range 1-5). Side effects were reported in 35.2%, which included eyelid erythema, conjunctival hyperemia, and punctal stenosis. None of the patients stopped treatment due to adverse effects. Patients who had partial response to 0.5% 5-FU had complementary treatment with surgery, Mitomycin-C and/or Interferon ⍺2b. Overall recurrence was 14.8%. Median follow-up was 14 months (range 2-92 months). In a multivariate Cox regression analysis, the risk of relapse was 84% lower in patients who had complete response to 0.5% 5-FU (p = 0.018).
CONCLUSION: Topical 0.5% 5-FU may be considered a safe and effective primary therapy for OSSN, with a low rate of side effects.
DESIGN: Retrospective study.
PARTICIPANTS: Patients with clinically suspected OSSN referred to a Brazilian tertiary health center between October 2015 and December 2022.
METHODS: After diagnostic confirmation of OSSN with exfoliative cytology, 0.5% 5-FU was administered topically 4 times daily for 2 weeks followed by a pause of 2 weeks.
RESULTS: A total of 54 patients were included in this study, 32 males (59.3%), mean age of 62.9 years old. Complete resolution of OSSN was achieved in 70.4%. The median number of cycles was 2 (range 1-5). Side effects were reported in 35.2%, which included eyelid erythema, conjunctival hyperemia, and punctal stenosis. None of the patients stopped treatment due to adverse effects. Patients who had partial response to 0.5% 5-FU had complementary treatment with surgery, Mitomycin-C and/or Interferon ⍺2b. Overall recurrence was 14.8%. Median follow-up was 14 months (range 2-92 months). In a multivariate Cox regression analysis, the risk of relapse was 84% lower in patients who had complete response to 0.5% 5-FU (p = 0.018).
CONCLUSION: Topical 0.5% 5-FU may be considered a safe and effective primary therapy for OSSN, with a low rate of side effects.
Предметные рубрики MeSH
HumansMaleFluorouracilRetrospective StudiesFemaleMiddle AgedAntimetabolites, AntineoplasticAgedOphthalmic SolutionsTreatment OutcomeCarcinoma, Squamous CellFollow-Up StudiesAdultAged, 80 and overAdministration, TopicalEye NeoplasmsConjunctival NeoplasmsCorneal DiseasesDose-Response Relationship, Drug