Fusconi M, Grasso M, Greco A, Gallo A, Campo F, Remacle M, Turchetta R, Pagliuca G, DE Vincentiis M
Department of Sensory Organs, Sapienza Università di Roma, Italy;
Department of Surgical Biotechnologies and Science, ENT Section, Sapienza Università di Roma, Italy;
Acta Otorhinolaryngol Ital. 2014 Dec;34(6):375-81.
Recurrent respiratory papillomatosis is a viral induced disease characterised by exophytic epithelial lesions affecting the larynx. The problem with its treatment is the high recurrence of papilloma growth after surgical removal. The aim of our review is to analyse the actual use of cidofovir, an agent used in adjuvant therapy. We have reviewed 6 manuscripts that included a total of 118 patients. The parameters taken into account were: concentration of infiltrated cidofovir (mg/ml), therapeutic response, relapse-free time (months), side effects, genotypes (HPV-6/11/18) and evolution of dysplasia. Cidofovir was injected at concentrations from 2.5 to 15 mg/ml, therapeutic response was from 56.25% to 82.3% and relapse-free time was from 10.05 to 49 months. There were 2 cases of dysplasia during therapy. Ten patients had been infected by HPV-6, 4 patients by HPV-11 and 10 patients by HPV-6 and HPV-11. The purposes of our review include the following: to stress that the juvenile form is more aggressive than other forms, to demonstrate than the drug has good adjuvant action although it does not significantly change the final response to the disease, to show that side effects are modest and, finally, to disprove the hypothesis that cidofovir may promote evolution towards dysplasia. In conclusion, combination of surgical removal and injection of cidofovir is associated with good response in recurrent respiratory papillomatosis.
复发性呼吸道乳头状瘤病是一种由病毒引起的疾病，其特征为喉部出现外生性上皮病变。其治疗的问题在于手术切除后乳头状瘤生长的高复发率。我们综述的目的是分析西多福韦（一种用于辅助治疗的药物）的实际应用情况。我们查阅了6篇手稿，共纳入118例患者。考虑的参数有：浸润的西多福韦浓度（mg/ml）、治疗反应、无复发时间（月）、副作用、基因型（HPV-6/11/18）以及发育异常的进展情况。西多福韦的注射浓度为2.5至15 mg/ml，治疗反应为56.25%至82.3%，无复发时间为10.05至49个月。治疗期间有2例发育异常。10例患者感染HPV-6，4例患者感染HPV-11，10例患者同时感染HPV-6和HPV-11。我们综述的目的包括以下几点：强调青少年型比其他类型更具侵袭性；证明该药物虽不能显著改变对疾病的最终反应，但具有良好的辅助作用；表明副作用较小；最后，反驳西多福韦可能促进向发育异常进展这一假说。总之，手术切除与注射西多福韦相结合对复发性呼吸道乳头状瘤病有良好的反应。
