Risk Factors for Ocular Surface Squamous Neoplasia Recurrence after Treatment With Topical Mitomycin C and Interferon Alpha-2b
Risk Factors for Ocular Surface Squamous Neoplasia Recurrence after Treatment With Topical Mitomycin C and Interferon Alpha-2b
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DOI：
10.1016/j.ajo.2013.10.012
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发表时间：
2014-02-01
影响因子：
4.2
通讯作者：
Vincent, Stephen J.
中科院分区：
文献类型：
--
作者：
Besley, Jenna;Pappalardo, Juanita;Vincent, Stephen J.
目得：确定使用丝裂霉素C（MMC）、干扰素α-2b或两者联合治疗非侵袭性眼表鳞状细胞瘤（OSSN）后的复发率和相关危险因素。设计：回顾性、非比较性、干预性病例系列。135例局部MMC连续治疗患者的临床实践背景（0.4 mg/mL）、干扰素α-2b（100万单位/mL）或两者联合治疗OSSN，观察临床复发情况。结果：局部治疗后，135只眼中有19只（14.1%）诊断出临床复发。平均复发时间为17.2个月（范围4 - 61个月），14只眼（73.7%）在2年内复发。对于包括病变大小、病变位置、性别、年龄、治疗类型或治疗持续时间在内的变量，未发现更大的复发风险。事后对数秩配对比较显示，最初仅使用手术治疗的病变显著缩短了复发时间（21.1 +/- 5.6个月），与既往MMC局部治疗相比（有或无手术; 29.6 +/- 4.7个月; P = .04）和原发性OSSN结论：局部MMC和干扰素α-2b是一种有效的治疗方法，用于广泛的非侵入性OSSN。局部治疗避免了切除手术的发病率，复发率相当或降低，应被视为主要治疗。(C)2014年，Elsevier Inc. All rights reserved.
PURPOSE: To determine the rate of recurrence and associated risk factors after the use of mitomycin C (MMC), interferon alpha-2b, or both for management of noninvasive ocular surface squamous neoplasia (OSSN).DESIGN: Retrospective, noncomparative, interventional case series.METHODS: Clinical practice setting of 135 patients treated consecutively with topical MMC (0.4 mg/mL), interferon alpha-2b (1 million units/mL), or both for OSSN observed for clinical recurrence.RESULTS: Clinical recurrences were diagnosed in 19 (14.1%) of 135 eyes after topical treatment. The mean time to recurrence was 17.2 months (range, 4 to 61 months), with 14 eyes (73.7%) recurring within a 2-year period. There was no greater risk of recurrence identified for variables including lesion size, lesion location, gender, age, treatment type, or treatment duration. Post hoc log-rank pairwise comparisons revealed that lesions initially treated using surgery alone had significantly reduced time to recurrence (21.1 +/- 5.6 months) compared with previous topical treatment with MMC (with or without surgery; 29.6 +/- 4.7 months; P = .04) and primary OSSN (23.2 +/- 1.8 months; P =.09).CONCLUSIONS: Topical MMC and interferon alpha-2b are an effective treatment method for a wide range of noninvasive OSSNs. Topical therapy avoids the morbidity of excisional surgery with equivalent or reduced recurrence rates and should be considered as primary therapy. (C) 2014 by Elsevier Inc. All rights reserved.