University Hospital Fundación Jiménez Diaz, Avenida Reyes Católicos 2, 28040, Madrid, Spain.
Ruber Juan Bravo Hospital, Madrid, Spain.
Int Ophthalmol. 2024 Apr 17;44(1):184. doi: 10.1007/s10792-024-03105-w.
To analyze the efficacy, safety and cost-effectiveness of adjuvant therapy with 5-fluorouracil (5-FU) compared to interferon α-2b (IFNα-2b) after surgery in ocular surface squamous neoplasia (OSSN).
Retrospective study that included patients diagnosed with OSSN, who underwent surgical excision followed by adjuvant therapy with IFN α-2b (Group A) or 5-FU (Group B), in a tertial referral hospital. Clinical data collected included: demographics, risk factors, appearance, size and location of the lesions, slit-lamp examination, anterior segment optical coherence tomography, iconography and histological classification of subtypes of OSSN. Costs derived from surgery and adjuvant therapy were noted. Resolution of the lesion, recurrences and adverse events were studied. Cost-effectiveness analysis was performed with the incremental cost-effectiveness index (CEI).
54 cases of 54 patients were included, with a mean age of 74.4 years (range 28-109). 30 were male (55.6%), and predominantly Caucasian (79.6%). The main risk factor was prolonged sun exposure (79.6%). Leukoplakic appearance (48.1%), location in bulbar conjunctiva (48.2%) and T3 (46.3%) stage were the most common clinical features. Histologically, the percentage of CIN I, CIN II, CIN III and SCC were 25.9%, 29.6%, 40.7% and 3.7%, respectively. Complete resolution was obtained in 74.1% and tolerance was overall positive. The cost was significantly higher for IFNα (1025€ ± 130.68€) compared to 5-FU (165.57€ ± 45.85 €) (p 0.001). The CEI was - 247.14€.
Both 5-FU and IFN α-2b are effective and present a good security profile as adjuvant therapies after surgery in OSSN. Although presenting slightly more ocular complications, 5-FU can be considered more cost-effective than IFN α-2b.
分析眼表面鳞状上皮肿瘤（OSSN）手术后辅助应用 5-氟尿嘧啶（5-FU）与干扰素 α-2b（IFNα-2b）的疗效、安全性和成本效益。
回顾性研究纳入在三级转诊医院接受手术切除并随后接受 IFNα-2b（A 组）或 5-FU（B 组）辅助治疗的 OSSN 患者。收集的临床数据包括：人口统计学、危险因素、病变外观、大小和位置、裂隙灯检查、眼前段光学相干断层扫描、影像学和 OSSN 亚型的组织学分类。记录手术和辅助治疗的费用。研究病变的消退、复发和不良反应。采用增量成本效益指数（CEI）进行成本效益分析。
共纳入 54 例 54 名患者，平均年龄 74.4 岁（范围 28-109）。30 例为男性（55.6%），主要为白种人（79.6%）。主要危险因素为长期暴露于阳光下（79.6%）。最常见的临床表现为白色斑块样外观（48.1%）、球结膜位置（48.2%）和 T3 期（46.3%）。组织学上，CIN I、CIN II、CIN III 和 SCC 的比例分别为 25.9%、29.6%、40.7%和 3.7%。完全缓解率为 74.1%，总体耐受性良好。IFNα 的费用明显更高（1025 欧元±130.68 欧元），而 5-FU 为 165.57 欧元±45.85 欧元（p<0.001）。CEI 为-247.14 欧元。
5-FU 和 IFNα-2b 均有效，作为 OSSN 手术后的辅助治疗具有良好的安全性。虽然 5-FU 引起眼部并发症的风险略高，但与 IFNα-2b 相比，5-FU 的成本效益更高。
