Kaliki Swathi, Bejjanki Kavya Madhuri, Desai Akruti, Mohamed Ashik
The Operation Eyesight Universal Institute for Eye Cancer (SK, KMB, AD), L V Prasad Eye Institute, Hyderabad, India.
Mark Nathaniel Thadikonda and Vijayamma Nannepaga Centre for Eye Care Education and Ophthalmic Biophysics (AM), L V Prasad Eye Institute, Hyderabad, India.
Semin Ophthalmol. 2019;34(7-8):465-472. doi: 10.1080/08820538.2019.1648691. Epub 2019 Aug 1.
To study the factors influencing the response to treatment with interferon alfa 2b (IFN) in ocular surface squamous neoplasia (OSSN)Methods: Retrospective study of 91 patientsResults: The mean age at presentation of patients with OSSN was 58 years (median, 60 years; range, 21 to 83 years). The mean number of clock hours of conjunctiva/cornea/limbus involvement by the tumor was 6 (median, 6; range, 1 to 12). The mean duration of topical IFN was 3 months (median, 3 months; range, 1 to 6 months) and the mean number of subconjunctival injections of IFN was 2 (median, 2; range, 0 to 6), till complete tumor regression or initiation of alternate treatment. Of 91 OSSN cases treated with IFN, 72 (79%) patients showed complete response to treatment, while 19 (21%) showed partial response displaying mean % tumor reduction of 34% (median, 20%; range, 5% to 90%). Patient demographics, immune status, disease chronicity, tumor location, or morphological pattern were not predictive of tumor response to IFN. The only factor predictive of incomplete response of OSSN to IFN was more than 6 clock hour involvement of ocular surface by OSSN ( = .04). Of 31 (34%) cases with OSSN >6 clock hours, 23 (74%) patients showed complete tumor regression with IFN alone, while 8 (26%) patients displayed incomplete response; and of 60 (66%) cases with OSSN ≤6 clock hours, 49 (82%) patients showed complete tumor regression with IFN alone, while 11 (18%) patients displayed incomplete response. Tumor recurrence was noted in 3% cases and one case had corneal perforation secondary to infective keratitis over a mean follow-up period of 14 months (median, 8 months; range, 3 to 58 months).
Clock hour involvement of ocular surface by OSSN determines the response to IFN. Interferon alfa 2b is an effective immunotherapy agent for tumors ≤6 clock hours of ocular surface in 82% cases and serves as an immunoreducing agent for larger tumors involving >6 clock hours of ocular surface in 26% cases.
研究影响眼表鳞状上皮肿瘤（OSSN）对干扰素α2b（IFN）治疗反应的因素。
对91例患者进行回顾性研究。
OSSN患者就诊时的平均年龄为58岁（中位数为60岁；范围为21至83岁）。肿瘤累及结膜/角膜/角膜缘的平均钟点数为6（中位数为6；范围为1至12）。局部使用IFN的平均持续时间为3个月（中位数为3个月；范围为1至6个月），结膜下注射IFN的平均次数为2次（中位数为2；范围为0至6），直至肿瘤完全消退或开始采用其他治疗方法。在91例接受IFN治疗的OSSN病例中，72例（79%）患者对治疗显示完全反应，而19例（21%）显示部分反应，肿瘤缩小的平均百分比为34%（中位数为20%；范围为5%至90%）。患者的人口统计学特征、免疫状态、疾病慢性程度、肿瘤位置或形态学模式均不能预测肿瘤对IFN的反应。OSSN对IFN反应不完全的唯一预测因素是OSSN累及眼表超过6个钟点（P = 0.04）。在31例（34%）OSSN累及超过6个钟点的病例中，23例（74%）患者仅使用IFN即可使肿瘤完全消退，而8例（26%）患者显示反应不完全；在60例（66%）OSSN累及≤6个钟点的病例中，49例（82%）患者仅使用IFN即可使肿瘤完全消退，而11例（18%）患者显示反应不完全。在平均14个月（中位数为8个月；范围为3至58个月）的随访期内，3%的病例出现肿瘤复发，1例因感染性角膜炎继发角膜穿孔。
OSSN累及眼表的钟点数决定了对IFN的反应。干扰素α2b对82%的眼表累及≤6个钟点的肿瘤是一种有效的免疫治疗药物，对26%的眼表累及超过6个钟点的较大肿瘤是一种免疫减效药物。
