Mandell David L, Arjmand Ellis M, Kay David J, Casselbrant Margaretha L, Rosen Clark A
Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, University of Pittsburgh Voice Center, University of Pittsburgh, Pittsburgh, PA, USA.
Arch Otolaryngol Head Neck Surg. 2004 Nov;130(11):1319-23. doi: 10.1001/archotol.130.11.1319.
To compare disease response among children with recurrent respiratory papillomatosis (RRP) who underwent combined surgical debulking and intralesional cidofovir injections vs repeated surgical debulking only.
Retrospective medical record review; follow-up range: 16 to 56 months.
Tertiary care children's hospital.
Seven children with RRP, including 4 subjects treated with cidofovir and 3 controls matched for age and initial papilloma staging score.
Subjects treated with cidofovir underwent combined surgical debulking and intralesional cidofovir injection every 2 months until disease remission. Control subjects underwent repeated surgical debulking at individually determined intervals.
Intraoperative endoscopic photographs were retrospectively assigned papilloma staging scores. Cidofovir and control group comparisons were made using nonparametric 2-sample Wilcoxon rank-sum (Mann-Whitney) testing, and comparisons of initial and final papilloma staging scores were made using nonparametric matched-pair Wilcoxon signed-rank testing.
The final cidofovir group scores were significantly lower than the control group scores (P < .05). Within-group differences between initial and final scores were not significant (cidofovir group, P = .07; control group, P = .29).
Four children with RRP were safely and successfully treated with intralesional cidofovir injection. Consideration should be given to using cidofovir more widely for treatment of pediatric RRP. Larger numbers in the cidofovir and control groups are needed in future studies to determine the true impact of cidofovir on management of this disease.
比较接受手术减瘤联合病灶内注射西多福韦与仅接受重复手术减瘤的复发性呼吸道乳头状瘤病（RRP）患儿的疾病反应。
回顾性病历审查；随访时间范围：16至56个月。
三级护理儿童医院。
7例RRP患儿，其中4例接受西多福韦治疗，3例为对照组，两组在年龄和初始乳头状瘤分期评分方面相匹配。
接受西多福韦治疗的患者每2个月进行一次手术减瘤联合病灶内注射西多福韦，直至疾病缓解。对照组患者在各自确定的间隔时间接受重复手术减瘤。
回顾性地为术中内镜照片指定乳头状瘤分期评分。使用非参数双样本Wilcoxon秩和（Mann-Whitney）检验对西多福韦组和对照组进行比较，使用非参数配对Wilcoxon符号秩检验对初始和最终乳头状瘤分期评分进行比较。
西多福韦组的最终评分显著低于对照组（P <.05）。组内初始和最终评分之间的差异不显著（西多福韦组，P =.07；对照组，P =.29）。
4例RRP患儿通过病灶内注射西多福韦得到了安全、成功的治疗。应考虑更广泛地使用西多福韦治疗儿童RRP。未来的研究需要增加西多福韦组和对照组的样本量，以确定西多福韦对该疾病治疗的真正影响。
