Yang Shuzhi, Zhou Chengyong, Sun Baochun, Wang Feng, Han Zeli, Zhang Hongjia, Han Jiahong, Shen Yao, Zhang Jiao
Department of Otolaryngology, The 4th Medical Center of the PLA General Hospital, Beijing, China.
Acta Otolaryngol. 2019 Dec;139(12):1133-1139. doi: 10.1080/00016489.2019.1667530. Epub 2019 Sep 26.
Recurrent respiratory papillomatosis (RRP) remains a challenging and frustrating disease to treat. To explore the efficacy of microsurgery in combined with Topical-PDT in treating recurrent respiratory papillomatosis. Fifty patients with RRP were treated with microsurgery in combined with Topical-PDT. Medical document of each patient was retrospectively reviewed. Detailed clinical information, metrics of clinical course, and current results were evaluated. Juvenile onset RRP (JORRP) might experience a more aggressive course than AORRP (adult onset RRP) with higher Derkay score ( < .01) and higher operation frequency per year ( < .01). Microsurgical excision combined with Topical-PDT every 25 days achieved "remission" of disease in 78% of patients, "clearance" of disease in 52%, and "Cured" in two patients. Each patient who achieved "remission" of disease, performed 6.82 ± 3.39 operations, and continued 8.93 ± 7.03 months of treatment duration. No statistically differences were found in these two aspects between JORRP and AORRP. A negative correlation between tracheotomy and the efficacy of microsurgery in combined with Topical-PDT was found ( = .025, Pearson's = -0.3). Microsurgery in combined with Topical-PDT might be a powerful method to treat RRP. Tracheotomy is a negative factor for this therapy.
复发性呼吸道乳头状瘤病（RRP）仍然是一种治疗起来具有挑战性且令人沮丧的疾病。为了探讨显微手术联合局部光动力疗法（Topical-PDT）治疗复发性呼吸道乳头状瘤病的疗效。对50例RRP患者采用显微手术联合局部光动力疗法进行治疗。对每位患者的医疗记录进行回顾性分析。评估详细的临床信息、临床病程指标和当前结果。青少年型RRP（JORRP）可能比成人型RRP（AORRP）病程更具侵袭性，Derkay评分更高（<0.01），每年手术频率更高（<0.01）。每25天进行一次显微手术切除联合局部光动力疗法，78%的患者疾病“缓解”，52%的患者疾病“清除”，两名患者“治愈”。每位达到疾病“缓解”的患者进行了6.82±3.39次手术，治疗持续时间为8.93±7.03个月。JORRP和AORRP在这两个方面未发现统计学差异。发现气管切开术与显微手术联合局部光动力疗法的疗效呈负相关（=0.025，Pearson相关系数=-0.3）。显微手术联合局部光动力疗法可能是治疗RRP的有效方法。气管切开术是该疗法的一个负面因素。
