Conjunctival Tumors and Their Radiotherapy

Lommatzsch, P

doi:10.1007/978-3-642-97011-5_25

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…When neoplastic cells are identified at the margins of resection of a conjunctival carcinoma a wide resection of the surgical scar with adjuvant cryotherapy is indicated. The use of radiotherapy is of limited value in the treatment of recurrent squamous carcinoma of the conjunctiva because radiotherapy can give rise to ocular side effects5 6 and because the beneficial effects of radiotherapy are necessarily limited to the treated areas. Therefore, a treatment modality selective for neoplastic cells, wherever located in the entire conjunctiva, may represent an effective approach for the treatment of recurrent CSCC and some selected cases of untreated tumours—diffuse and poorly demarcated tumours, patients refusing surgery, or in poor health.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of conjunctival squamous cell carcinoma with topical 5-fluorouracil

Midena

2000

British Journal of Ophthalmology

152

115

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Aim-To evaluate the eYcacy of topical 5-fluorouracil (5-FU) alone, without concurrent surgery or radiotherapy, for the treatment of conjunctival squamous cell carcinoma. Methods-Eight patients aVected by conjunctival squamous cell carcinoma (three recurrent cases, three incompletely excised, and two untreated cases) were treated with 1% 5-FU eye drops. Topical 1% 5-FU was administered four times daily for 4 weeks (one course). Clinical examination (biomicroscopy and photography) and morphological evaluation of conjunctival cytological specimens were used to monitor the eYcacy of local chemotherapy, side eVects, and recurrences. Results-All patients showed clinical regression of conjunctival carcinoma after topical 1% 5-FU treatment. Neoplastic conjunctiva was completely replaced by normal epithelium within 3 months. Mean follow up was 27 months. One patient needed two courses of local chemotherapy for recurrent disease. An acute transient toxic keratoconjunctivitis was observed in all treated cases; it was easily controlled with topical therapy. No long term side eVects were found. Conclusions-Topical 1% 5-FU is eVective in the treatment of recurrent, incompletely excised, and selected untreated conjunctival squamous cell carcinomas. Topical 1% 5-FU has no major complications. This study suggests that topical conjunctival chemotherapy with 1% 5-FU may be useful, at least as adjunctive therapy, in the treatment of conjunctival squamous cell carcinoma. (Br J Ophthalmol 2000;84:268-272)

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Section: Discussionmentioning

confidence: 99%

“…Moreover, recurrences may be multiple and their occurrence greatly increases the risk of local spread 4. Local irradiation is sometimes used in conjunction with repeated excision to treat conjunctival recurrences of squamous cell carcinoma5 6; however, side effects limit the use of supplemental irradiation.…”

mentioning

confidence: 99%

Treatment of conjunctival squamous cell carcinoma with topical 5-fluorouracil

Midena

2000

British Journal of Ophthalmology

152

115

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“…Moreover, recurrences may be multiple and their occurrence greatly increases the risk of local spread 8. Local irradiation is sometimes used in conjunction with repeated excision to treat conjunctival recurrences of squamous cell carcinoma 9–10. However, side effects limit the use of supplemental irradiation.…”

Section: Introductionmentioning

confidence: 99%

“…β-irradiation,9 topical urea,10 and immunotherapy,11 have been shown to reduce recurrence rates. Topical interferon-α-2b has also been proposed as a possible medical alternative to surgical excision of primary or recurrent intraepithelial neoplasia 12.…”

Section: Introductionmentioning

confidence: 99%

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

Al-Barrag¹

2010

OPTH

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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.

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“…Among these, plaque radiotherapy using different isotopes has become the treatment of choice in most ocular oncology departments. Pioneered in the 1960s by Lommatzsch, the use of Ru-106 applicators as a beta emitter in a variety of sizes and shapes is one of the most commonly used radioactive plaques popularized in the treatment of UM [ 5 ]. Although brachytherapy using Ru-106 plaques has been recommended for small to medium-sized tumors up to 5 mm in thickness [ 6 ], multiple clinical studies have reported anatomical success with large tumors up to 11 mm in thickness [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Ruthenium-106 plaque radiotherapy for uveal melanoma: analysis of tumor dimension and location on anatomical and functional results

et al. 2022

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Background To report the long-term outcomes of Ru-106 plaque radiotherapy in eyes with uveal melanoma (UM) and to assess the effect of tumor thickness and location on final outcomes. Methods Medical records of 234 patients undergoing Ru-106 plaque radiotherapy for UM were reviewed, and the visual outcome, globe preservation, and patient survival were evaluated. The results of 2 groups were compared: 1. between thin (small and medium-sized, thickness < 7 mm, 148 eyes [63.2%]) and thick (thickness ≥ 7 mm, 86 eyes [36.8%]) tumors, and 2. between large (largest basal diameter [LBD] > 12 mm, 109 eyes [46.6%]) and medium/small (LBD ≤ 12 mm, 125 eyes [53.4%]). In addition, a comparison of the juxtapapillary location in 46 eyes (19.7%) versus tumors arising elsewhere and between tumors with and without ciliary involvement in 48 eyes (21.5%) were done. Results The patients were followed for a median of 54.2 months (range: 6–194.5 months). After adjusting for baseline visual acuity (VA), there was no significant association between final VA and different dimension and tumor location groups. Final globe preservation was 91.9%, and there was no significant difference between different dimension- and ciliary body involvement groups regarding anatomical success rate. The juxtapapillary tumors had lower globe preservation (80.4% vs .94.7%, p = 0.002). The hazard ratio (HR) for enucleation in juxtapapillary tumors was HR = 6.58 (95-CI: 3.84 to 11.21). The overall metastasis rate was 6.8%, with no significant difference in juxtapapillary tumors (4.3% vs.7.4%, p = 0.455). Conclusions Ru-106 plaque radiotherapy is an effective treatment for thick and large UM. With this type of treatment, the globe preservation rate is lower in juxtapapillary tumors, but there is no significant difference in the metastasis rate.

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Conjunctival Tumors and Their Radiotherapy

Cited by 5 publications

References 22 publications

Treatment of conjunctival squamous cell carcinoma with topical 5-fluorouracil

Treatment of conjunctival squamous cell carcinoma with topical 5-fluorouracil

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

Ruthenium-106 plaque radiotherapy for uveal melanoma: analysis of tumor dimension and location on anatomical and functional results

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