Eficácia do colírio de 5-fluorouracil 0,5% no tratamento de neoplasias escamosas da superfície ocular
Data
2024-09-13
Autores
Teixeira, Gabriela Carneiro 
Orientadores
Fernandes, Arthur Gustavo
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Avaliar a eficácia do tratamento com 5-Fluorouracil (5-FU) 0,5% em casos de neoplasias escamosas da superfície ocular (NESO) no Ambulatório de Oncologia Ocular do Departamento de Oftalmologia e Ciências Visuais da Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), assim como a tolerância dos pacientes submetidos ao tratamento. Métodos: Os pacientes foram tratados com colírio de 5-FU 0,5%, 01 gota de 6 em 6 horas por 10 dias, seguido de pausa de 3 semanas, sendo este período total de 31 dias definido como um ciclo de tratamento. As lesões foram avaliadas antes do início do tratamento e após cada ciclo da medicação. Em caso de resposta parcial, até 3 ciclos da medicação poderiam ser prescritos. O tratamento foi suspenso em caso de ausência de resposta, progressão da lesão, ou intolerância à medicação. A aderência ao tratamento foi avaliada através do questionário Morisky Medication Adherence, e pacientes considerados não-aderentes foram excluídos do estudo. Os efeitos adversos apresentados durante o tratamento foram notados. A análise estatística foi realizada para identificar fatores associados ao sucesso terapêutico.
Resultados: Um total de 30 olhos de 30 pacientes considerados aderentes ao tratamento foram incluídos no estudo. Vinte e quatro pacientes tratados com 5-FU 0,5% apresentaram resolução total da lesão após 21,71±7,77 dias de uso da medicação, cerca de 2 ciclos de tratamento, representando uma taxa de sucesso de 80% (95% IC: 60,75 – 91,18%). Para cada 1 mm2 a mais da área da lesão, a taxa de sucesso terapêutico do 5-FU 0,5% diminui em 6% (Razão de chance: 0,94; 95% IC: 0,88 – 0,99; p=0,033). Apenas efeitos adversos leves foram relatados por 8 pacientes durante o tratamento: desconforto ocular, ardor ocular, lacrimejamento, e ardor palpebral. Nenhum paciente foi excluído do estudo por intolerância à medicação.
Conclusão: O 5-FU 0,5% tópico, apesar da concentração menor que a estabelecida na literatura (1%), também é uma opção terapêutica eficaz para o tratamento primário das neoplasias escamosas da superfície ocular, com a taxa de sucesso de 80% no estudo realizado. O 5-FU 0,5% também mostrou boa tolerabilidade pelos pacientes. O tamanho da lesão foi identificado como um fator associado ao sucesso terapêutico, devendo ser levado em consideração para a definição do tratamento de escolha.
Purpose: To evaluate the efficacy of topical treatment with 5-Fluorouracil (5-FU) 0,5% in cases of Ocular Surface Squamous Neoplasia (NESO), and to assess the tolerance of patients undergoing treatment. Methods: Patients with clinical diagnosis of NESO referred to the Ocular Oncology division from the Federal University of Sao Paulo, Brazil, were recruited for the current study. Patients were treated with topical 5-FU 0,5% using a regimen of 4 times daily for 10 days, followed by a 3-week drug holiday, continued up to 3 times before an alternative treatment. Lesions were evaluated at baseline and throughout treatment. Treatment adherence was assessed using the Morisky Medication Adherence scale. Any adverse events along the treatment were noted. Results: A total of 30 eyes of 30 patients adherent to the treatment were included in the study. Among the total cases treated with 5-FU 0.5%, 24 patients achieved therapeutic success after a mean treatment duration of 21,71±7,77 days, 2 cycles of medication, representing a success rate of 80% (95% CI: 60,75 – 91,18%). For each 1 mm2 increase in the lesion area, the odds of treatment success decrease by 6% (OR: 0,94; 95%CI: 0,88 – 0,99; p=0,033). Only mild adverse events such as ocular discomfort, ocular burning and tearing we Purpose: To evaluate the efficacy of topical treatment with 5-Fluorouracil (5-FU) 0,5% in cases of Ocular Surface Squamous Neoplasia (NESO), and to assess the tolerance of patients undergoing treatment. Methods: Patients with clinical diagnosis of NESO referred to the Ocular Oncology division from the Federal University of Sao Paulo, Brazil, were recruited for the current study. Patients were treated with topical 5-FU 0,5% using a regimen of 4 times daily for 10 days, followed by a 3-week drug holiday, continued up to 3 times before an alternative treatment. Lesions were evaluated at baseline and throughout treatment. Treatment adherence was assessed using the Morisky Medication Adherence scale. Any adverse events along the treatment were noted. Results: A total of 30 eyes of 30 patients adherent to the treatment were included in the study. Among the total cases treated with 5-FU 0.5%, 24 patients achieved therapeutic success after a mean treatment duration of 21,71±7,77 days, 2 cycles of medication, representing a success rate of 80% (95% CI: 60,75 – 91,18%). For each 1 mm2 increase in the lesion area, the odds of treatment success decrease by 6% (OR: 0,94; 95%CI: 0,88 – 0,99; p=0,033). Only mild adverse events such as ocular discomfort, ocular burning and tearing were observed along the treatment in 8 patients. Conclusions: Topical 5-FU 0,5% is an effective therapeutic option in the treatment of OSSN, with an 80% therapeutic success rate, showing good tolerability. The size of the lesion was identified as a factor influencing treatment success, therefore it should be taken into consideration when defining treatment approaches.re observed along the treatment in 8 patients. Conclusions: Topical 5-FU 0,5% is an effective therapeutic option in the treatment of OSSN, with an 80% therapeutic success rate, showing good tolerability. The size of the lesion was identified as a factor influencing treatment success, therefore it should be taken into consideration when defining treatment approaches.
Purpose: To evaluate the efficacy of topical treatment with 5-Fluorouracil (5-FU) 0,5% in cases of Ocular Surface Squamous Neoplasia (NESO), and to assess the tolerance of patients undergoing treatment. Methods: Patients with clinical diagnosis of NESO referred to the Ocular Oncology division from the Federal University of Sao Paulo, Brazil, were recruited for the current study. Patients were treated with topical 5-FU 0,5% using a regimen of 4 times daily for 10 days, followed by a 3-week drug holiday, continued up to 3 times before an alternative treatment. Lesions were evaluated at baseline and throughout treatment. Treatment adherence was assessed using the Morisky Medication Adherence scale. Any adverse events along the treatment were noted. Results: A total of 30 eyes of 30 patients adherent to the treatment were included in the study. Among the total cases treated with 5-FU 0.5%, 24 patients achieved therapeutic success after a mean treatment duration of 21,71±7,77 days, 2 cycles of medication, representing a success rate of 80% (95% CI: 60,75 – 91,18%). For each 1 mm2 increase in the lesion area, the odds of treatment success decrease by 6% (OR: 0,94; 95%CI: 0,88 – 0,99; p=0,033). Only mild adverse events such as ocular discomfort, ocular burning and tearing we Purpose: To evaluate the efficacy of topical treatment with 5-Fluorouracil (5-FU) 0,5% in cases of Ocular Surface Squamous Neoplasia (NESO), and to assess the tolerance of patients undergoing treatment. Methods: Patients with clinical diagnosis of NESO referred to the Ocular Oncology division from the Federal University of Sao Paulo, Brazil, were recruited for the current study. Patients were treated with topical 5-FU 0,5% using a regimen of 4 times daily for 10 days, followed by a 3-week drug holiday, continued up to 3 times before an alternative treatment. Lesions were evaluated at baseline and throughout treatment. Treatment adherence was assessed using the Morisky Medication Adherence scale. Any adverse events along the treatment were noted. Results: A total of 30 eyes of 30 patients adherent to the treatment were included in the study. Among the total cases treated with 5-FU 0.5%, 24 patients achieved therapeutic success after a mean treatment duration of 21,71±7,77 days, 2 cycles of medication, representing a success rate of 80% (95% CI: 60,75 – 91,18%). For each 1 mm2 increase in the lesion area, the odds of treatment success decrease by 6% (OR: 0,94; 95%CI: 0,88 – 0,99; p=0,033). Only mild adverse events such as ocular discomfort, ocular burning and tearing were observed along the treatment in 8 patients. Conclusions: Topical 5-FU 0,5% is an effective therapeutic option in the treatment of OSSN, with an 80% therapeutic success rate, showing good tolerability. The size of the lesion was identified as a factor influencing treatment success, therefore it should be taken into consideration when defining treatment approaches.re observed along the treatment in 8 patients. Conclusions: Topical 5-FU 0,5% is an effective therapeutic option in the treatment of OSSN, with an 80% therapeutic success rate, showing good tolerability. The size of the lesion was identified as a factor influencing treatment success, therefore it should be taken into consideration when defining treatment approaches.
Descrição
Citação
TEIXEIRA, Gabriela Carneiro. Eficácia do colírio de 5-fluorouracil 0,5% no tratamento de neoplasias escamosas da superfície ocular. 2024. 33 f. Dissertação (Mestrado Profissionlal em Tecnologia, Gestão e Saúde Ocular) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2024.