Nayani Divya, Kasireddy Mounika, Shankar T, Kumar Pitale Ashok Rahul, Reddy L Sudarshan
Department of Otorhinolaryngology, Government ENT Hospital, Osmania Medical College, Door No.5-1-174, Opposite State Bank of India Head Office, Bank Street Road Koti, Hyderabad, 500095 India.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):3800-3806. doi: 10.1007/s12070-024-04612-z. Epub 2024 May 7.
Recurrent respiratory papillomatosis is an aggressive benign disease characterised by the repeated growth of multiple warts involving the larynx as well as other parts of the respiratory tract. Recurrent respiratory papillomatosis is most commonly caused by human papillomaviruses 6 and 11. It requires multiple surgical procedures for tumour debulking.Our study aims to evaluate the impact and potential of adjuvant intralesional bevacizumab in the treatment of recurrent respiratory papillomatosis while providing valuable insights based on a case series analysis.A prospective study of a total of 13 patients with Recurrent respiratory papillomatosis attending a tertiary care hospital with ages ranging from 3 to 30 years was conducted from February 2018 to February 2023 by intralesional bevacizumab 1 ml with a concentration of 2.5 mg/ml per dose, 3 injections, each once every 4 weeks by calculating the number of operative procedures per year, duration of time between procedures, calculating the Derkay score before 1 year of the first injection and after 1 year of the last dose injection of bevacizumab treatment. Inclusion criteria are ages between 3 and 30 years with recurrent respiratory papillomatosis who underwent at least 4 or more surgical procedures with no adjuvant therapies. In all our cases, the affected area was the larynx.Adjuvant therapy with intralesional bevacizumab increases the duration of time between surgical procedures and reduces the number of operative procedures each year with an overall improvement in the Derkay score. No adverse drug effects have been reported in our study.Intralesional Bevacizumab is an effective and safe adjuvant treatment option for recurrent respiratory papillomatosis. It increases the duration of time between surgical procedures and decreases the number of procedures per year with an overall improvement in the Derkay score.
复发性呼吸道乳头状瘤病是一种侵袭性良性疾病，其特征是喉部以及呼吸道其他部位反复长出多个疣。复发性呼吸道乳头状瘤病最常见的病因是人乳头瘤病毒6型和11型。它需要多次手术来切除肿瘤。我们的研究旨在评估辅助性瘤内注射贝伐单抗在复发性呼吸道乳头状瘤病治疗中的影响和潜力，同时基于病例系列分析提供有价值的见解。2018年2月至2023年2月，对一家三级医院收治的13例年龄在3至30岁之间的复发性呼吸道乳头状瘤病患者进行了一项前瞻性研究，采用浓度为2.5mg/ml的贝伐单抗1ml进行瘤内注射，共注射3次，每4周注射一次，通过计算每年的手术次数、两次手术之间的时间间隔、在首次注射前1年和贝伐单抗治疗最后一剂注射后1年计算德凯评分。纳入标准为年龄在3至30岁之间、患有复发性呼吸道乳头状瘤病且至少接受过4次或更多次手术且未接受辅助治疗的患者。在我们所有的病例中，受累部位均为喉部。瘤内注射贝伐单抗进行辅助治疗可延长手术间隔时间，减少每年的手术次数，德凯评分总体改善。我们的研究中未报告药物不良反应。瘤内注射贝伐单抗是复发性呼吸道乳头状瘤病一种有效且安全的辅助治疗选择。它可延长手术间隔时间，减少每年的手术次数，德凯评分总体改善。
