Intralesional cidofovir in severe juvenile respiratory papillomatosis.

Abstract

UNLABELLED:

Recurrent respiratory papillomatosis causes significant morbidity among affected children and usually requires frequent surgeries. We present a prospective case series including nine children at a Mexican tertiary referral center. All enrolled patients had severe disease that had required at least four surgical procedures, with a median of 6. Two children had tracheobronchial involvement, one had lung parenchymal disease, and one had a tracheostomy performed during his first surgery.

OBJECTIVE:

To assess the efficacy of intralesional cidofovir in lowering the surgery rate.

STUDY DESIGN:

Prospective case series.

SETTING:

Tertiary referral center in Mexico City.

METHODS:

Nine Mexican children with severe disease were enrolled. Intralesional cidofovir was applied after surgical debulking at a concentration of 5 mg/mL with a four to six week interval.

RESULTS:

Six of the nine patients had a notable decrease in the rate of surgeries, with three patients remaining disease-free with follow up ranging from 1.8 to 3.3 years. No patient demonstrated laboratory abnormalities. Two patients showed moderate and mild dysplasia on papilloma biopsy distinguished by a lack of epithelial maturation with no mitoses or cellular atypia. Two patients died several months after the last injection.

CONCLUSIONS:

Intralesional cidofovir appears to be effective in the treatment of recurrent respiratory papillomatosis, although further studies are required to determine its safety.

• Authors: Y Ablanedo-Terrazas, A Soda-Merhy, M Hernández-Palestina, C E Ormsby, G Reyes-Terán
• Journal: B-ENT (B-ENT) Vol. 8 Issue 3 Pg. 197-202 ( 2012) ISSN: 1781-782X [Print] Belgium
• PMID: 23113383 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Organophosphonates
• Cytosine
• Cidofovir

Topics

• Antineoplastic Agents (administration & dosage)
• Child
• Child, Preschool
• Cidofovir
• Cytosine (administration & dosage, analogs & derivatives)
• Dose-Response Relationship, Drug
• Female
• Follow-Up Studies
• Humans
• Infant
• Injections, Intralesional
• Laryngeal Neoplasms (diagnosis, drug therapy)
• Male
• Neoplasm Staging
• Organophosphonates (administration & dosage)
• Papilloma (diagnosis, drug therapy)
• Prospective Studies
• Severity of Illness Index
• Time Factors
• Treatment Outcome