Treatment of conjunctival squamous cell carcinoma with topical 5-fluorouracil

Abstract

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)

Altered gene expression in conjunctival squamous cell carcinoma

“…Cryotherapy, radiation, and chemotherapy have been used after excision to reduce recurrence rates. Topical mitomycin C, 9 5-fluorouracil, 10 and interferon alpha-2b 11,12 have been successfully used for recurrent lesions.…”

Excision and cryosurgery of conjunctival malignant epithelial tumours

“…1 In addition to cryotherapy, other modalities of adjunctive therapy include radiotherapy, which is reported to offer excellent tumour control rates. 13,14 Currently, there is great interest in the use of topical chemotherapy (interferon, 15 mitomycin C (MMC) 16 and 5-fluorouracil 17 ). Topical chemotherapy is generally advocated where tumour excision is not feasible or incomplete; such treatment has also been used as primary treatment or as secondary treatment for recurrent tumours.…”

In vivo confocal microscopy of ocular surface squamous neoplasia

“…1 The main treatment modality for these lesions should be wide local excision and accurate histological assessment of surgical margins. 2 Moreover, topical conjunctival chemotherapy with antineoplastic drugs has recently been proposed in OSSN management, as adjuvant or, in selected cases, sole treatment. [2][3] Diagnosis and follow-up of OSSN are essentially based on clinical findings followed by histopathologic confirmation.…”

“…2 Moreover, topical conjunctival chemotherapy with antineoplastic drugs has recently been proposed in OSSN management, as adjuvant or, in selected cases, sole treatment. [2][3] Diagnosis and follow-up of OSSN are essentially based on clinical findings followed by histopathologic confirmation. 2 Tissue diagnosis is commonly performed by excisional biopsy in smaller lesions, or map biopsy in multifocal-larger lesions.…”

“…[2][3] Diagnosis and follow-up of OSSN are essentially based on clinical findings followed by histopathologic confirmation. 2 Tissue diagnosis is commonly performed by excisional biopsy in smaller lesions, or map biopsy in multifocal-larger lesions. 1,2 An alternative tool for tissue diagnosis is cytologic sampling using scraping or impression technique.…”