Preoperative topical and intraoperative local mitomycin C adjuvant therapy in the management of ocular surface neoplasias

Abstract

Aims: To demonstrate the efficacy of mitomycin C as adjuvant therapy preoperatively and intraoperatively in the management of recurrent or diffuse ocular surface neoplasias. Methods: The case notes of 11 patients receiving mitomycin C adjuvant therapy as 0.04% eye drops four times a day in two weekly courses preoperatively and/or a single intraoperative application of 0.4 mg/ml of mitomycin C were reviewed. The histopathology included conjunctival primary acquired melanosis, conjunctival melanomas, sebaceous cell carcinomas with conjunctival intraepithelial spread, and conjunctival intraepithelial squamous neoplasias. Seven patients had additional limited local excision of the residual tumour mass and one had cryotherapy. Results: All cases showed a favourable response to mitomycin C adjuvant therapy with regression in size or retardation of a rapid growth pattern and no serious sequelae. Postoperative follow up of 6-36 months following excision of the lesion with or without intraoperative mitomycin C showed no clinical recurrence in any of the cases. Conclusion: In this series, mitomycin C adjuvant therapy of recurrent or diffuse ocular surface neoplasias was well tolerated and showed favourable clinical results.

Topical Mitomycin C for the Treatment of Conjunctival Tumor

“…MMC has been commonly used for the treatment of ocular surface neoplasias particularly for the in-situ carcinoma form [6, 8]. Neoadjuvant, adjuvant or primary therapies with the drug have been reported [3, 4, 8]. Using the drug has many advantages, including avoidance of the side effects of large surgical excision such as stem-cell deficiency and corneal scarring [9].…”

Uso de mitomicina C em neoplasia intra-epitelial córneo-conjuntival: modalidades de abordagem - relato de casos

“…A mitomicina C (MMC) atua inibindo a síntese do DNA, sendo mais eficaz em células com divisão rápida (10) . Esse agente tem sido utilizado como adjuvante para excisão de NIC e de CEC no pré-operatório (11) , no intra-operatório (11)(12) e no pós-operatório (13) . Por outro lado, há estudos que recomendam seu uso como terapia primária para NIC/CEC, mesmo na doença recorrente (10,(14)(15)(16)(17) .…”

Systemic absorption of mitomycin-C when used in refractive surgery

“…Mitomycin-C is a chemotherapeutic agent with principle toxicity of myelosuppression, hepatotoxicity, and renal toxicity. 5,6 Delayed oncogenesis remains a ubiquitous concern of chemotherapeutic agents. Paroni et al 4 were able to quantify plasma absorption and correlate it with the potential for toxicity.…”