Pransky S M, Magit A E, Kearns D B, Kang D R, Duncan N O
Pediatric Otolaryngology, Children's Hospital and Health Center, San Diego, Calif 92123, USA.
Arch Otolaryngol Head Neck Surg. 1999 Oct;125(10):1143-8. doi: 10.1001/archotol.125.10.1143.
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.
Prospective case series.
Tertiary care children's hospitals.
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.
Microsuspension laryngoscopy with intralesional injection of cidofovir (Vistide) in conjunction with mechanical debulking and carbon dioxide laser of papillomas.
Papilloma stage at time of serial laryngoscopies.
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.
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.
评估病灶内注射西多福韦（一种对多种DNA病毒有活性的无环核苷膦酸盐）对治疗儿科患者严重呼吸道乳头状瘤的潜在益处。
前瞻性病例系列。
三级护理儿童医院。
5名患有严重复发性呼吸道乳头状瘤病的儿科患者，需要每月进行一次以上的二氧化碳激光喉镜检查以维持气道通畅。在注射西多福韦之前，每位患者接受了12至33次激光喉镜检查。
病灶内注射西多福韦（Vistide）的显微喉镜检查，联合机械减瘤和乳头状瘤二氧化碳激光治疗。
系列喉镜检查时的乳头状瘤分期。
1例患者疾病缓解，3例患者在最后一次注射西多福韦后的9个月随访中对西多福韦辅助治疗表现出显著反应。1例患者乳头状瘤分期改善，可能与同时使用干扰素治疗有关。
病灶内注射西多福韦似乎对治疗儿科患者严重呼吸道乳头状瘤病有益。在西多福韦被视为治疗这种难治性疾病的公认方法之前，需要进行更大规模、随访时间更长的前瞻性研究。
