Adjuvant 5-fluorouracil in the treatment of localised ocular surface squamous neoplasia.
OBJECTIVE
To report the outcome of treatment of localised non-invasive ocular surface squamous neoplasia (OSSN) where topical 5-fluorouracil (5-FU 1%) is used as an adjuvant to surgical excision.


METHODS
The study was a prospective non-comparative interventional case series. 55 cases of primary localised OSSN and 10 cases of recurrent localised OSSN were treated with excision, cryotherapy and adjuvant 5-FU 1%. In all cases, irrespective of the involvement of surgical margins, a single cycle of 5-FU 1% was administered, four times a day for 2 weeks continuously. The main outcome measures were (1) recurrence and (2) complications related to adjuvant topical chemotherapy. Individuals were reviewed for a minimum of 12 months.


RESULTS
There was a single case of recurrence (1.5%). 57% of patients had short-term complications secondary to 5-FU 1%, most frequently lid toxicity (49%), followed by superficial keratitis, epiphora and corneal epithelial defects. Four patients were unable to complete the course of 5-FU 1% because of local toxicity.


CONCLUSIONS
The management of localised non-invasive OSSN with adjuvant 5-FU 1% was associated with a low rate of local recurrence. Although 5-FU 1% frequently results in short-term complications, most commonly lid toxicity, a full course is usually tolerated. Serious complications appear uncommon in the treatment of localised disease.
South Australian Institute of Ophthalmology, c/o Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia. rudkin.adam@gmail.com
Adam K
AK
Rudkin
James S
JS
Muecke
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005134:Eye Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000601:surgery; D018307:Neoplasms, Squamous Cell / Q000188:drug therapy* / Q000601:surgery; D011446:Prospective Studies; D016896:Treatment Outcome; D014785:Vision, Ocular / Q000502:physiology
D000970:Antineoplastic Agents; D005472:Fluorouracil