Intralesional cidofovir for recurrent respiratory papillomatosis in children

被引:88
作者
Pransky, SM
Magit, AE
Kearns, DB
Kang, DR
Duncan, NO
机构
[1] Childrens Hosp & Hlth Ctr, San Diego, CA 92123 USA
[2] Univ Calif San Diego, Sch Med, Div Otolaryngol, San Diego, CA 92103 USA
[3] San Diego Naval Med Ctr, San Diego, CA USA
[4] Texas Ear Nose & Throat Consultants, Houston, TX USA
关键词
D O I
10.1001/archotol.125.10.1143
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objective: To assess the potential benefit of intralesional administration of cidofovir, an acyclic nucleoside phosphonate with activity against several DNA viruses, for treating severe respiratory papillomas in pediatric patients. Design: Prospective case series. Setting: Tertiary care children's hospitals. Patients: Five pediatric patients with severe recurrent respiratory papillomatosis requiring laryngoscopy with carbon dioxide laser therapy more frequently than once a month to maintain airway patency. Each patient underwent between 12 and 33 laryngoscopies with laser treatment prior to being injected with cidofovir. Intervention: Microsuspension laryngoscopy with intralesional injection of cidofovir (Vistide) in conjunction with mechanical debulking and carbon dioxide laser of papillomas. Main Outcome Measure: Papilloma stage at time of serial laryngoscopies. Results: One patient was disease free and 3 patients demonstrated a dramatic response to adjuvant therapy with cidofovir at the 9-month follow-up visit after the last injection of cidofovir. One patient showed an improvement in papilloma stage that was possibly related to concurrent therapy with interferon. Conclusions: Intralesional injection of cidofovir seems to be of benefit in the treatment of severe respiratory papillomatosis in pediatric patients. Larger prospective studies with longer follow-up, will be required before cidofovir can be considered an accepted means of managing this difficult disease.
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页码:1143 / 1148
页数:6
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