Empleo de interferón alfa-2b para el tratamiento de carcinomas conjuntivales intraepiteliales en casos seleccionados

  1. N Toledano Fernández
  2. S García Sáenz
  3. D Díaz Valle
  4. A Arteaga Sánchez
  5. M Segura Bedmar
  6. S Lorenzo Giménez
  7. L Cortés Lambea
Journal:
Archivos de la Sociedad Española de Oftalmologia

ISSN: 0365-6691

Year of publication: 2003

Volume: 78

Issue: 5

Pages: 265-271

Type: Article

DOI: 10.4321/S0365-66912003000500006 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Archivos de la Sociedad Española de Oftalmologia

Abstract

Purpose: To study the efficacy of topical and combined topical and subconjunctival interferon alfa 2b (IFN alfa 2b) in the treatment of recurrent conjunctival intraepithelial neoplasia (CIN) in those patients who present resistance or intolerance to topical mitomycin C (MMC) treatment or when it is not indicated. Methods: Four patients (age range from 52 to 70) with histological confirmation of recurrent CIN were studied prospectively. Two patients were resistant to topical MMC, another one did not tolerate it, and in the last case, this treatment was not indicated due to a stem cell insufficiency associated to a trophic corneal ulcer. Three patients were given just topical interferon (1 million IU/ ml four times a day for three months), while the last one received topical therapy and subconjunctival IFN alfa 2b injections (3 millions IU/ 0.5 ml) . Results: Complete regression of the tumour was evident in all cases. sixteen to 24 months after treatment no patient had clinical evidence of recurrence. No side effects were observed in any patient, not even with subconjunctival administration. Conclusions: IFN alfa 2b is effective as an alternative treatment to topical MMC in selected cases of recurrent CIN.

Bibliographic References

  • Wilson, MW, Hungerford, JL, George, SM, Madreperla, SA. (1997). Topical mitomycin C for the treatment of conjunctival and corneal epithelial dysplasia and neoplasia. Am J Ophthalmol. 124. 303-311
  • Frucht- Pery, J, Sugar, J, Baum, J, Sutphin, JE, Pe´er, J, Savir, H. (1997). Mitomycin C treatment for conjunctival- corneal intraepithelial neoplasia: a multicenter experience. Ophthalmology. 104. 2085-2093
  • Vann, RR, Karp, CL. (1999). Perilesional and topical interferon alfa- 2b for conjunctival and corneal neoplasia. Ophthalmology. 106. 91-97
  • Shields, JA, Shields, CL, De Potter, P. (1997). Surgical management of conjunctival tumors: The 1994 Lynn B. Mc Mahan Lecture. Arch Ophthalmol. 115. 808-815
  • Frucht- Pery, J, Rozenman, Y. (1994). Mitomycin C therapy for corneal intraepithelial neoplasia. Am J Ophthalmol. 117. 164-168
  • Heigle, TJ, Stulting, RD, Palay, DA. (1997). Treatment of recurrent conjunctival epithelial neoplasia with topical mitomycin C. Am J Ophthalmol. 124. 397-399
  • Yeatts, RP, Engelbrecht, NE, Curry, CD, Ford, JG, Walter, KA. (2000). 5- Fluorouracil for the treatment of intraepithelial neoplasia of the conjunctiva and cornea. Ophthalmology. 107. 2190-2195
  • Cerezo, L, Otero, J, Aragón, G, Polo, E, de la Torre, A, Valcárcel, F. (1990). Conjunctival intraepithelial and invasive squamous cell carcinomas treated with strontium-90. Radiother Oncol. 17. 191-197
  • Dausch, D, Landesz, M, Schröder, E. (1994). Phototherapeutic keratectomy in recurrent corneal intraepithelial dysplasia. Arch Ophthalmol. 112. 22-23
  • Talamo, JH, Gollamudi, S, Green, R, De la Cruz, Z, Filatov, V, Stark, WJ. (1991). Modulation of corneal wound healing after excimer laser keratomileusis using topical mitomycin C and steroids. Arch Ophthalmol. 109. 1141-1146
  • Schechter, BA. (1999). Conjunctival intraepithelial neoplasia. Ophthalmolgy. 106. 1642-1643
  • Salomao, DR, Mathers, W, Sutphin, JE, Cuevas, K, Folberg, R. (1999). Cytologic changes in the conjunctiva mimicking malignancy after topical mitomycin C chemotherapy. Ophthalmology. 106. 1756-1761
  • Yamamoto, N, Ohmura, T, Suzuki, H, Shirasawa, H. (2002). Succesful treatment with 5- fluorouracil of conjunctival intraepithelial neoplasia refractive to mitomycin- C. Ophthalmology. 109. 249-252
  • Maskin, SL. (1994). Regression of limbal epithelial dysplasia with topical interferon. Arch Ophthalmol. 112. 1145-1146
  • Baron, S, Tyring, SK, Fleischmann, WR, Coppenhaver, DH, Niessel, DW, Klimpel, GR. (1991). The interferons: Mechanisms of action and clinical applications. JAMA. 266. 1375-1383
  • Edwards, L, Berman, B, Rapini, RP, Whiting, DA, Tyring, S, Greenway, HT Jr. (1992). Treatment of cutaneous squamous cell carcinomas by intralesional interferon alfa- 2b therapy. Arch Dermatol. 128. 1486-1489
  • Lee, GA, Williams, G, Hirst, LW, Green, AC. (1994). Risk factors in the development of ocular surface epithelial dysplasia. Ophthalmology. 101. 360-364
  • Mc Donnell, JM, Mc Donnell, PJ, Sun, YY. (1992). Human papillomavirus DNA in tissues and ocular swabs of patients with conjunctival epithelial neoplasia. Invest Ophthalmol Vis Sci. 33. 184-189
  • Karp, CL, Scott, IU, Chang, TS, Pflugfelder, SC. (1996). Conjunctival intraepithelial neoplasia: A possible marker for human inmunodeficiency virus infection?. Arch Ophthalmol. 114. 257-261
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