Dyrstad Sara W, Rao Krishna A
Department of Internal Medicine, Southern Illinois University School of Medicine, 415 North Ninth Street, Post Office Box 19678, Springfield, IL 62794-9678 U.S.A.
Clin Med Oncol. 2008;2:481-6. doi: 10.4137/cmo.s698. Epub 2008 Jul 18.
In this article, we describe the treatment of long standing juvenile-onset recurrent respiratory papillomatosis (JORRP) with eventual transformation to carcinoma in a patient who lived to the age of 73. Treatment modalities consisted of bronchoscopy and local excision initially. Later, YAG and CO2 laser debulking were used. Radiotherapy, chemotherapy with carboplatin (300 mg/m2) and 5-FU (600 mg/m2), oral methotrexate (5-7.5 mg/week), pegylated Interferon, indole-3-carbamide, and intralesional cidofovir were also utilized in the treatment of this patient. Except for methotrexate, each of the treatment regimens used in this patient, initially decreased growth of the papillomas and improved symptoms experienced by the patient. Interestingly, we found that this patient's long standing JORRP initially responded to a chemotherapy regimen of 4 cycles of carboplatin (300 mg/m2) and 5-FU (600 mg/m2) as well. Ultimately, the disease became resistant to all forms of treatment and progressed. The patient eventually succumbed to the disease after an approximate 77 year course.
在本文中，我们描述了一名活到73岁的长期青少年期复发性呼吸道乳头状瘤病（JORRP）最终转化为癌症的治疗情况。治疗方式最初包括支气管镜检查和局部切除。后来，使用了YAG和CO2激光减瘤治疗。还采用了放射治疗、卡铂（300mg/m²）和5-氟尿嘧啶（600mg/m²）化疗、口服甲氨蝶呤（5-7.5mg/周）、聚乙二醇化干扰素、吲哚-3-甲酰胺和病灶内注射西多福韦来治疗该患者。除甲氨蝶呤外，该患者使用的每种治疗方案最初都能减少乳头状瘤的生长并改善患者的症状。有趣的是，我们发现该患者的长期JORRP最初对4个周期的卡铂（300mg/m²）和5-氟尿嘧啶（600mg/m²）化疗方案也有反应。最终，该疾病对所有治疗形式均产生耐药并进展。在经历了约77年病程后，患者最终死于该疾病。
