Broekema Ferdinand I, Dikkers Frederik G
Department of Otorhinolaryngology, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
Eur Arch Otorhinolaryngol. 2008 Aug;265(8):871-9. doi: 10.1007/s00405-008-0658-0. Epub 2008 May 6.
Recurrent respiratory papillomatosis (RRP) is a chronic and difficult to treat disease of the larynx. In 1998, the first article was published that described the use of the antiviral substance cidofovir to treat this disease. Although the results are promising, there remains some concern about the potential carcinogenicity of cidofovir. There is a demand for a qualitative review of the side-effects of this medicine. In this review, the side-effects of cidofovir are investigated. Special attention was given to the potential carcinogenicity of cidofovir. For this review a search is performed in PubMed and EMBASE for relevant articles in which the use of intralesional cidofovir for patients with RRP is described. Eventually, 31 articles could be included for this review. In these articles a total of 188 patients with RRP were described who underwent therapy with intralesional cidofovir. Five of these patients have developed dysplasia of the larynx during the treatment with cidofovir. This is a percentage of 2.7. This percentage is concurrent with the incidence of spontaneous malignant degeneration of RRP (2-3%). Based on this review, it can be concluded that the use of intralesional cidofovir does not increase the risk of laryngeal dysplasia. Apart from the articles that describe the intralesional administration of cidofovir, some articles have been published in which the use of intravenous cidofovir is described as a therapy for RRP. Therefore, a summary is given on the side-effects of intralesional cidofovir as well as a summary on the reported side-effects of the intravenous administration of cidofovir. Based on the outcomes of this review, recommendations are given for a safe use of cidofovir for treatment of recurrent respiratory papillomatosis in the future.
复发性呼吸道乳头状瘤病（RRP）是一种慢性且难以治疗的喉部疾病。1998年，首篇描述使用抗病毒药物西多福韦治疗该疾病的文章发表。尽管结果令人鼓舞，但人们仍对西多福韦的潜在致癌性有所担忧。因此需要对该药的副作用进行定性综述。在本综述中，对西多福韦的副作用进行了研究。特别关注了西多福韦的潜在致癌性。为进行本综述，在PubMed和EMBASE中检索了描述对RRP患者使用病灶内注射西多福韦的相关文章。最终，31篇文章被纳入本综述。这些文章共描述了188例接受病灶内注射西多福韦治疗的RRP患者。其中5例患者在接受西多福韦治疗期间发生了喉部发育异常。这一比例为2.7%。该比例与RRP自发恶性变的发生率（2 - 3%）一致。基于本综述，可以得出结论，病灶内注射西多福韦不会增加喉部发育异常的风险。除了描述病灶内注射西多福韦的文章外，还有一些文章发表，其中描述了将静脉注射西多福韦用作RRP的一种治疗方法。因此，对病灶内注射西多福韦的副作用以及静脉注射西多福韦所报道的副作用进行了总结。基于本综述的结果，给出了关于未来安全使用西多福韦治疗复发性呼吸道乳头状瘤病的建议。
