A useful adjuvant treatment for SNAC or IP
Reviewed by Joanna Stephens

5-Fluorouracil (5FU) is a topical preparation used in the treatment of various dermatological, ocular and gynaecologic malignant and pre-malignant conditions, and this literature review looks at the efficacy of 5FU in treating inverted papilloma and sinonasal tumours. The authors cite a number of papers which support the use of 5FU postoperatively, following total resection of sinonasal adenocarcinoma either via craniofacial resection or transnasal endoscopic approach, with good results. For inverted papilloma, two papers cite good results with 5FU – a case series of 18, with the initial case in an 11-year-old female with multiple recurrences (a highly unusual case!) followed by 17 additional patients after initial success. The authors applied the 5FU topically using a soaked gauze which was left in situ for seven to 10 days postoperatively, and only one of the 18 patients developed a recurrence. These were difficult cases where it was hard to ascertain complete removal. Alternative methods of application were frontal trephination or bi-weekly packing for six weeks, and smaller sample sizes but similarly good results. Whilst the number of cases discussed here is understandably small and the study design only a retrospective review, this is a useful adjuvant treatment available for those recurrent cases of difficult sites of origin of tumour. As the authors state, we do not yet have enough data to advocate the routine use of 5FU, so more research would be welcomed.

Topical application of 5-Fluorouracil for the treatment of sinonasal adenocarcinoma and inverted papilloma.
Revercomb L, Patel A, Filimonov I, Lerner D.
AM J RHINOL ALLERG
2024;38(5):354–60.