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R. Parrozzani, F. Urban, M. Gurabardhi, V. de Belvis, A. Ghirlando, E. Midena; Long Term Outcome of Topical 1% 5-Fluoruracil in the Management of Corneo-Conjunctival Ocular Surface Squamous Neoplasia. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5735.
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to evaluate retrospectively, on a long-term range, the clinical outcomes of topical 1% 5-Fluoruracil (5-FU) as a sole or adjuvant treatment of Ocular Surface Squamous Neoplasia (OSSN).
thirty-eight consecutive cases of OSSN were included in this non-comparative case series. Patients underwent topical chemotherapy with 5-FU four times/day for 4 weeks (one course) as a sole or adjuvant treatment. Follow-up was performed monthly until complete clinical and cytological resolution and every six months thereafter. Retreatment was based on both cytological and clinical findings. Clinical Confocal Microscopy (CCM) was used to check for 5-FU long-term corneal toxicity. Follow-up was longer than 60 months.
follow-up was 87±14 months (range, 61-115 months). Among thirty-eight consecutive cases, nineteen patients (44.8%) underwent topical 5-FU as a sole treatment, sixteen patients (42.1%) underwent surgery followed by adjuvant 5-FU, whereas 3 patients (7,9%) underwent de-bulking topical 5-FU followed by surgery and adjuvant 5-FU. Mean 5-FU cycles were 1.9 (range, 1-5 cycles). Only transient and reversible low-to-mild 5-FU local side effects (toxic keratoconjunctivitis) were documented in all treated eyes. Three tumors (7,9%) treated with 5-FU alone recurred during follow-up. Recurrences were treated with additional 5-FU courses, with complete tumor eradication. CCM showed no long-term statistically difference between treated eye and fellow (control) eye in: endothelial cells density and morphology, stromal keratocytes density, sub-basal nerve plexus fibres number and density and central cornea epithelium thickness (p>0.05).
topical 5-FU, as a sole or surgical combined therapy, is a long-term safe and effective treatment for patients affected by OSSN, and it should be considered as the first choice in the topical therapy of these tumors.
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