Al-Barrag Abdulmoghni, Al-Shaer Mutahar, Al-Matary Nabil, Al-Hamdani Mohammed
Ophthalmic Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Republic of Yemen.
Clin Ophthalmol. 2010 Jul 30;4:801-8. doi: 10.2147/opth.s9709.
To evaluate the efficacy and risks of complications of pulse dosing of topical 5-fluorouracil (5-FU) in the treatment of corneal intraepithelial neoplasia (CIN), and conjunctival squamous cell carcinoma (SCC).
Prospective, noncomparative case series.
Fifteen patients with histological evidence CIN or SCC of the conjunctiva and cornea were identified by tumor biopsy.
All patients clinically evident of CIN, or SCC were evaluated, with maximum 30 months of follow-up were treated with pulsed dosing of 1% 5-FU. Treatment cycles were defined as four times per day for 4 days using the medication followed by 30 days without medication. The number of initial treatment was six cycles.
The mean age of the 15 patients was 50.8 years (range 25-78 years). Excision biopsy proved seven cases as CIN, and eight cases as locally invasive SCC. All patients remained disease free with a mean follow-up of 14.53 months (range 6-30 months). Additional chemotherapy was given after the initial treatment cycles, only for one case. 5-FU caused mild temporary local irritation, but no long-term intraocular or extra ocular complications.
Adjuvant 1% topical 5-FU appears to be effective in the prevention of recurrence of conjunctival or corneal CIN and SCC after excision biopsy. Our results indicate that at least six cycles of topical 1% 5-FU is required to prevent local recurrence in the long term. It is well-tolerated and an effective method of treatment. No complications that would preclude use of our dose regimen were noted.
评估脉冲给药局部应用5-氟尿嘧啶（5-FU）治疗角膜上皮内瘤（CIN）和结膜鳞状细胞癌（SCC）的疗效及并发症风险。
前瞻性、非对照病例系列。
通过肿瘤活检确定15例有结膜和角膜CIN或SCC组织学证据的患者。
对所有临床诊断为CIN或SCC的患者进行评估，随访最长30个月，采用1% 5-FU脉冲给药治疗。治疗周期定义为每天用药4次，连续4天，然后停药30天。初始治疗次数为6个周期。
15例患者的平均年龄为50.8岁（范围25 - 78岁）。切除活检证实7例为CIN，8例为局部浸润性SCC。所有患者均无疾病复发，平均随访14.53个月（范围6 - 30个月）。仅1例患者在初始治疗周期后接受了额外化疗。5-FU引起轻度短暂局部刺激，但无长期眼内或眼外并发症。
辅助局部应用1% 5-FU似乎对预防切除活检后结膜或角膜CIN和SCC的复发有效。我们的结果表明，至少需要6个周期的局部应用1% 5-FU才能长期预防局部复发。它耐受性良好，是一种有效的治疗方法。未观察到会妨碍使用我们剂量方案的并发症。
