Recombinant interferon alpha 2b for ocular surface squamous
Purpose : The purpose was to study the efficacy of interferon alpha 2b (INF ?2b) in the treatment of ocular surface squamous neoplasia (OSSN) and analyze its cost-effectiveness in India.

Study Design : This was a retrospective study of thirty patients with OSSN treated with topical INF ?2b (1 MIU/cc) ± perilesional INF ?2b (5 MIU/cc).

Results : The tumor involved cornea (n = 9, 30%), conjunctivo-limbal-corneal surface (n = 19, 63%), or bulbar conjunctiva (n = 2, 7%). The mean basal dimension of the tumor was 16 mm. The tumors belonged to Tis (n = 6, 20%) or T3 (n = 24, 80%) based on the American Joint Committee Classification, 7th edition. In the six patients with Tis, three cycles of topical INF ?2b were used for immunoprevention. In the remaining 24 patients, INF ?2b was advised for immunoreduction, but served as immunotherapy with 100% tumor regression in 22 (92%) cases, and resulted in 95% immunoreduction in 2 (6%) cases. Complete tumor regression by immunotherapy (n = 22) was achieved with a mean number of three topical INF ?2b cycles and two perilesional injections. All these 22 patients received three additional topical INF ?2b cycles after complete tumor regression. For immunoreduction (n = 2), both patients received six cycles of topical INF ?2b which was three perilesional INF ?2b injections. The mean total treatment cost per patient with INF ?2b was INR 9164 ($US 137). Based on maximum basal diameter of tumor at presentation, the mean total treatment cost per patient with INF ?2b was INR 4866 ($US 73) for eyes with microscopic evidence of tumor residue (n = 6), INR 9607 ($US 143) for tumors ?10 mm (n = 13), and INR 10,985 ($US 164) for tumors >10 mm (n = 11), with two patients needing additional surgical excision for complete tumor control.

Conclusion : INF ?2b can be used for immunoreduction, immunotherapy, or immunoprevention of OSSN. INF ?2b is a cost-effective treatment modality for OSSN at an average total treatment cost of INR 9164 ($US 137) per patient.

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