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. 2010 Jul 30:4:801-8.
doi: 10.2147/opth.s9709.

5-Fluorouracil for the treatment of intraepithelial neoplasia and squamous cell carcinoma of the conjunctiva, and cornea

Abdulmoghni Al-Barrag  1 , Mutahar Al-Shaer, Nabil Al-Matary, Mohammed Al-Hamdani
Affiliations

5-Fluorouracil for the treatment of intraepithelial neoplasia and squamous cell carcinoma of the conjunctiva, and cornea

Abdulmoghni Al-Barrag et al. Clin Ophthalmol. .

Abstract

Objective: 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).

Design: Prospective, noncomparative case series.

Participants: Fifteen patients with histological evidence CIN or SCC of the conjunctiva and cornea were identified by tumor biopsy.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: chemotherapy; fluorouracil; neoplasia; treatment cycles.

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Figures

Figure 1A
Figure 1A
Extensive carcinoma in-situ at the time of presentation, involving most of the bulbar conjuctiva, imparting a gelatinous appearance to the conjunctiva and camouflaging the conjuctival vessels.
Figure 1B
Figure 1B
Appearance of the eye 3 months after the initial treatment cycle with topical 5-FU.
Figure 1C
Figure 1C
Appearance of the eye 5 months after the initial treatment cycle with topical 5-FU.
Figure 2A
Figure 2A
Right conjunctival intraepithelial neoplasia, with severe dysplasia at presentation.
Figure 2B
Figure 2B
Right eye appearance after 6 months of 5-FU.
Figure 3A
Figure 3A
Left eye, well diffentiated squamous cell carcinoma at presentation.
Figure 3B
Figure 3B
Left eye, appearance after four months treatment by 5-FU.
See this image and copyright information in PMC

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