Purpose

To evaluate the long-term follow-up of recurrent conjunctival and corneal intraepithelial neoplasia (CCIN) treated with combination topical interferon alfa-2b and retinoic acid (I/RA).

Methods

Our study represents a retrospective observational interventional series of 82 eyes from 82 patients from a single institution, reviewed for CCIN. All were administered topical interferon alfa-2b 1 million IU/mL QID and retinoic acid 0.01% every other day. Patients had been diagnosed by biopsy. A Kaplan-Meier survival analysis, Wilcoxon signed-rank test and a multivariate logistic regression were statistical tests used to correlate recurrence with patient and tumor variables.

Results

79 eyes assessed for CCIN diagnoses and treated with I/RA achieved tumor resolution. The median tumor-free follow-up was ~109.1 months with a median time to resolution being ~2.8 months. Our median treatment duration was ~11.3 months. The greatest difference in the mean total residual tumor size was identified between Months 0–1 [-7.63 mm²]. The difference in mean total residual tumor size remained significant till 36-months. A statistically significant correlation with recurrence was identified for biopsy type [OR 0.138]. 6 patients experienced papillary conjunctivitis which resolved with dosage reduction.

Conclusions

Combination I/RA was effective in treating CCIN lesions with few transient side effects. The combination of retinoids and interferons may represent a viable topical therapeutic agent with an extended tumor-free follow-up and a large proportion of our study's patients achieving >10 year's tumor-free follow-up. Our treatment duration is long, but by cost-comparing surgical against medical interventions, topical I/RA may serve as a safe and effective alternative.

中文翻译：

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干扰素α-2b和视黄酸治疗结膜复发和角膜上皮内瘤变：约9年随访。

目的

为了评估长期联合使用局部干扰素α-2b和视黄酸（I / RA）联合治疗结膜和角膜上皮内瘤样变（CCIN）的长期随访。

方法

我们的研究代表了回顾性观察性干预性系列研究，该研究来自单一机构的82例患者的82只眼，均接受CCIN审查。每隔一天都给予局部干扰素alfa-2b 1,000,000 IU / mL QID和0.01％的视黄酸。患者已通过活检确诊。Kaplan-Meier生存分析，Wilcoxon符号秩检验和多元逻辑回归是用于将复发与患者和肿瘤变量相关联的统计学检验。

结果

评估CCIN诊断并接受I / RA治疗的79只眼睛达到了肿瘤消退的目的。中位无肿瘤随访时间约为109.1个月，中位治愈时间约为2.8个月。我们的中位治疗时间为〜11.3个月。在第0个月至第1个月[-7.63 mm ² ]之间发现了平均总残留肿瘤大小的最大差异。直到36个月，平均总残留肿瘤大小的差异仍然显着。对于活检类型，发现与复发有统计学意义[OR 0.138]。6例患者出现乳头状结膜炎，可通过减少剂量解决。

结论

I / RA组合可有效治疗CCIN病变，且几乎没有短暂的副作用。类维生素A和干扰素的组合可能是一种可行的局部治疗药物，具有延长的无肿瘤随访时间，并且我们研究的患者中有很大一部分达到了> 10年的无肿瘤随访时间。我们的治疗时间长，但是通过比较手术费用与医疗干预费用，局部I / RA可以作为安全有效的替代方法。