Chadha Neil K, James Adrian L
Department of ENT Otolaryngology-Head and Neck Surgery, Torbay Hospital, Torquay, Devon, United Kingdom.
Otolaryngol Head Neck Surg. 2007 Jun;136(6):863-9. doi: 10.1016/j.otohns.2006.09.007.
To determine the efficacy of antiviral agents for recurrent respiratory papillomatosis (RRP) in children and adults.
Systematic review to include randomized controlled trials (RCTs), comparative studies (historical and/or nonrandomized), case series, and case reports.
Twenty-six original studies were included (one case-control series, 21 noncomparative trials, four case reports, and no RCTs). Meta-analysis was not possible. The antiviral modalities included acyclovir, ribavirin, intravenous cidofovir, and intralesional cidofovir injections. The strongest evidence was for intralesional cidofovir, with 17 studies including 158 patients. Of these, 90 patients (57%) demonstrated complete resolution, 55 patients (35%) a partial response, and 13 patients (8%) showed no improvement.
Insufficient evidence from controlled trials exists for reliable conclusions, but several series indicate intralesional cidofovir may have some efficacy. A well-designed placebo-controlled, double-blinded, randomized controlled trial is needed.
This study provides the background for future study design and a comprehensive review of the available evidence.
确定抗病毒药物对儿童和成人复发性呼吸道乳头状瘤病（RRP）的疗效。
系统评价，纳入随机对照试验（RCT）、比较研究（历史对照和/或非随机对照）、病例系列和病例报告。
纳入26项原始研究（1个病例对照系列、21项非对照试验、4例病例报告，无RCT）。无法进行荟萃分析。抗病毒治疗方式包括阿昔洛韦、利巴韦林、静脉注射西多福韦和病灶内注射西多福韦。证据最充分的是病灶内注射西多福韦，有17项研究，共158例患者。其中，90例患者（57%）症状完全缓解，55例患者（35%）部分缓解，13例患者（8%）无改善。
对照试验证据不足，无法得出可靠结论，但多个系列研究表明病灶内注射西多福韦可能有一定疗效。需要开展设计良好的安慰剂对照、双盲随机对照试验。
本研究为未来的研究设计提供了背景，并对现有证据进行了全面综述。
