Efficacy of topical 5-Fluorouracil in the management of ocular surface squamous neoplasia: a study of 101 eyes

• Published in: International ophthalmology 2024-06, Vol.44 (1), p.251, Article 251
• Main Authors: Bakal, Komal, Molugu, Sanjana, Machakuri, Khaleel, Bejjanki, Kavya Madhuri, Kapoor, Anasua Ganguly, Kaliki, Swathi
• Format: Article
• Language: English
• Subjects: 5-Fluorouracil; Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Antimetabolites, Antineoplastic - administration & dosage; Biopsy; Cancer therapies; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - pathology; Child; Conjunctiva; Conjunctival Neoplasms - diagnosis; Conjunctival Neoplasms - drug therapy; Conjunctival Neoplasms - pathology; Cornea; Corneal Diseases - diagnosis; Corneal Diseases - drug therapy; Effectiveness; Enucleation; Eye; Eye (anatomy); Eye cancer; Eye Neoplasms - diagnosis; Eye Neoplasms - drug therapy; Female; Fluorouracil - administration & dosage; Follow-Up Studies; Humans; Hyperemia; Keratitis; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmic Solutions - administration & dosage; Ophthalmology; Original Paper; Patients; Retrospective Studies; Side effects; Squamous cell carcinoma; Stem cells; Stenosis; Treatment Outcome; Tumors; Young Adult
• ISSN: 1573-2630; 0165-5701; 1573-2630
• DOI: 10.1007/s10792-024-03182-x

Objective To study the efficacy and side-effect profile of topical 5-Fluorouracil (5-FU) in the treatment of ocular surface squamous neoplasia (OSSN). Methods Retrospective study of 101 eyes of 100 patients treated with 5-FU with one week on and 3 weeks off regimen. Results Of the 100 patients (101 eyes), the mean age at diagnosis of OSSN was 49 (median, 52 years; range, 11–87 years). History of prior intervention was noted in 6 (6%) eyes. Tumor epicenter included bulbar conjunctiva (n = 54; 53%), limbus (n = 27; 27%), and cornea (n = 20;20%). Mean number of cycles of topical 5-FU administered was 3 (median, 3; range, 1–8). Complete tumor regression was achieved with topical 5-FU in 89 (88%) eyes with a mean number of 2 cycles (median, 2; range, 1–6) of 5-FU. The remaining 12 (12%) lesions underwent additional treatment including excisional biopsy (n = 7), extended enucleation (n = 3), and topical Interferon alpha 2b (n = 2) for complete tumor control. Over a mean follow-up period of 6 months (median, 5 months; range, 1–36 months) following treatment, tumor recurrence was noted in 2 (2%) patients, and side-effects were noted in 7 (7%) eyes including conjunctival hyperemia (n = 1), punctal stenosis (n = 1), sterile keratitis (n = 4), and limbal stem cell deficiency (n = 1). Conclusion Topical 5-FU is an effective non-invasive therapy for OSSN with a minimal side-effect profile.