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德国三家眼科中心干扰素-α2b 治疗上皮细胞肿瘤和黑色素瘤的现状调查。

Current Practice in the Treatment of Epithelial and Melanocytic Tumours with Interferon-α2b: A Survey of Tertiary Eye Centres in Germany.

机构信息

Eye Center, University Medical Center Freiburg, Germany.

Department of Ophthalmology, University Hospital Regensburg, Germany.

出版信息

Klin Monbl Augenheilkd. 2023 Jul;240(7):891-896. doi: 10.1055/a-2029-0163. Epub 2023 Feb 6.

Abstract

PURPOSE

To evaluate the standard of care, in particular the use of topical or subconjunctival interferon-2b, in treating ocular surface squamous neoplasia or melanocytic tumours in tertiary eye centres in Germany.

METHODS

A survey containing 14 questions was sent to 43 tertiary eye centres in Germany. The questions addressed the surgical and medical management of ocular surface squamous neoplasia and melanocytic tumours (primary acquired melanosis and malignant melanoma), as well as the clinical experiences and difficulties in prescribing off-label interferon-2b eye drops and subconjunctival injections.

RESULTS

Twenty-four tertiary eye centres responded to the survey. Eighty-three percent of centres had used interferon-2b in their clinical practice and 25% prescribed it as the first-line cytostatic agent following surgical excision of ocular surface squamous neoplasia, while 10% would do so for melanocytic tumours. Correspondingly, the majority of respondents selected mitomycin C as their first-line agent. Side effects were uncommon with topical interferon-2b eye drops but were more frequently reported after subconjunctival interferon-2b injections. In total, eight centres had experience with interferon-2b injections. The most significant obstacles perceived by ophthalmologists when prescribing interferon-2b were its high cost and the reimbursement thereof.

CONCLUSION

Off-label mitomycin C was the preferred adjuvant therapy for epithelial and melanocytic tumours, with interferon-2b being the standard second-line option. Interferon-2b has predominantly been used to treat ocular surface squamous neoplasia and, to a lesser extent, melanocytic tumours at German tertiary eye centres. Following its market withdrawal, supply shortages of interferon-2b are likely to have a profound impact on patient care and their quality of life.

摘要

目的

评估德国三级眼科中心在治疗眼表鳞状上皮肿瘤或黑色素细胞肿瘤方面的护理标准,特别是使用局部或结膜下干扰素-2b 的情况。

方法

向德国 43 家三级眼科中心发送了一份包含 14 个问题的调查问卷。这些问题涉及眼表鳞状上皮肿瘤和黑色素细胞肿瘤(原发性获得性黑色素沉着和恶性黑色素瘤)的手术和药物治疗,以及开具非标签干扰素-2b 滴眼剂和结膜下注射的临床经验和困难。

结果

24 家三级眼科中心对调查做出了回应。83%的中心在临床实践中使用过干扰素-2b,25%的中心在切除眼表鳞状上皮肿瘤后将其作为一线细胞抑制剂,而 10%的中心会将其用于黑色素细胞肿瘤。相应地,大多数受访者选择丝裂霉素 C 作为一线药物。局部使用干扰素-2b 滴眼剂的副作用不常见,但结膜下注射干扰素-2b 的副作用更为常见。总共有 8 家中心有使用干扰素-2b 注射的经验。眼科医生在开具干扰素-2b 时遇到的最大障碍是其高昂的成本及其报销问题。

结论

非标签丝裂霉素 C 是上皮和黑色素细胞肿瘤的首选辅助治疗药物,而干扰素-2b 是标准的二线选择。干扰素-2b 主要用于治疗眼表鳞状上皮肿瘤,在德国三级眼科中心也有较少用于治疗黑色素细胞肿瘤。在其退出市场后,干扰素-2b 的供应短缺可能会对患者的护理和生活质量产生深远的影响。

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