Benedict Jacob J, Derkay Craig S
Department of Otolaryngology - Head and Neck Surgery, Eastern Virginia Medical School Sentara Norfolk General Hospital Norfolk Virginia USA.
Department of Otolaryngology - Head and Neck Surgery, Eastern Virginia Medical School Children's Hospital of the King's Daughters Norfolk Virginia USA.
Laryngoscope Investig Otolaryngol. 2021 Mar 13;6(2):340-345. doi: 10.1002/lio2.545. eCollection 2021 Apr.
Despite recent advancement recurrent respiratory papillomatosis (RRP) remains a rare but challenging benign airway neoplasm. In recent years there has been significant shifts in incidence of this disease due to changes in vaccination and prevention for human papilloma virus (HPV) and its related pathology. This review will highlight the epidemiology, prevention and treatment of RRP.
The PubMed database was searched using relevant MeSH terms including "recurrent respiratory papillomatosis." The titles and abstracts were reviewed to assess relevance and unrelated articles were excluded. A full-text review for select articles was performed, the data and discussions were interpreted and synthesized to create a concise update on the management of RRP.
With the increasing utilization of the 9-valent and quadrivalent HPV vaccine in Australia, we have seen a significant decrease in the incidence of RRP. Preliminary data in the US shows a similar trend of decreased incidence after implementation of vaccination. Single dose Gardasil in developing countries has shown sustained immunization for at least 7 years. Preliminary clinical trials and retrospective studies have shown the HPV vaccine may have benefit as a treatment method in addition to prevention for HPV related diseases. Bevacizumab (Avastin), a VEGF monoclonal antibody, has shown promise as a systemic treatment for RRP. The Corona Virus Disease 2019 (COVID-19) pandemic has affected perioperative management of RRP.
RRP continues to decline in incidence since the implementation of HPV vaccination. Advancement in the medical management including Bevacizumab show promise as an additional option for the management of RRP.
尽管近年来取得了进展，但复发性呼吸道乳头状瘤病（RRP）仍然是一种罕见但具有挑战性的良性气道肿瘤。近年来，由于人乳头瘤病毒（HPV）疫苗接种和预防措施及其相关病理学的变化，该疾病的发病率发生了显著变化。本综述将重点介绍RRP的流行病学、预防和治疗。
使用包括“复发性呼吸道乳头状瘤病”在内的相关医学主题词在PubMed数据库中进行检索。对标题和摘要进行审查以评估相关性，排除不相关的文章。对选定文章进行全文审查，对数据和讨论进行解释和综合，以创建关于RRP管理的简明更新。
随着9价和4价HPV疫苗在澳大利亚的使用增加，我们看到RRP的发病率显著下降。美国的初步数据显示，接种疫苗后发病率也有类似的下降趋势。发展中国家的单剂量加德西疫苗已显示出至少7年持续免疫效果。初步临床试验和回顾性研究表明，HPV疫苗除了预防HPV相关疾病外，作为一种治疗方法可能也有益处。贝伐单抗（阿瓦斯汀），一种VEGF单克隆抗体，已显示出作为RRP全身治疗的前景。2019年冠状病毒病（COVID-19）大流行影响了RRP的围手术期管理。
自实施HPV疫苗接种以来，RRP的发病率持续下降。包括贝伐单抗在内的医学管理进展显示出作为RRP管理的额外选择的前景。
