Avidano M A, Singleton G T
Department of Otolaryngology-Head and Neck Surgery, University of Florida College of Medicine, Gainesville.
Otolaryngol Head Neck Surg. 1995 Feb;112(2):197-202. doi: 10.1016/S0194-59989570236-9.
The purpose of this study was to evaluate adjuvant drug therapies combined with standard laser excision in the treatment of recurrent respiratory papillomatosis. Previous studies have presented conflicting data on the efficacy of various treatments, including interferon and isotretinoin. A retrospective study of 34 patients with moderate to severe papillomatosis who underwent both laser surgery and adjuvant therapy was therefore performed. All patients were treated with interferon. Five interferon failures received isotretinoin, and three with recalcitrant disease received methotrexate. Interferon produced a complete response in 16 patients and partial response in 12 patients. Juvenile-onset disease had a slightly higher response to interferon than adult-onset disease. isotretinoin produced no response in all five patients. Methotrexate demonstrated a marked improvement in both severity of disease and treatment interval in all three patients. Serious side effects were limited to one interferon patient with febrile seizures, which resolved with discontinuation of therapy. We conclude that adjuvant therapy including interferon and methotrexate is clearly of benefit in the treatment of patients with respiratory papillomatosis. A detailed approach to surgery combined with an interferon dosing regimen is presented. Further study of methotrexate appears warranted.
本研究的目的是评估辅助药物治疗联合标准激光切除术治疗复发性呼吸道乳头状瘤病的效果。先前的研究对于包括干扰素和异维A酸在内的各种治疗方法的疗效给出了相互矛盾的数据。因此，对34例接受了激光手术和辅助治疗的中重度乳头状瘤病患者进行了一项回顾性研究。所有患者均接受干扰素治疗。5例对干扰素治疗无效的患者接受了异维A酸治疗，3例患有顽固性疾病的患者接受了甲氨蝶呤治疗。干扰素治疗使16例患者完全缓解，12例患者部分缓解。青少年发病的疾病对干扰素的反应略高于成人发病的疾病。5例接受异维A酸治疗的患者均无反应。甲氨蝶呤使所有3例患者的疾病严重程度和治疗间隔均有显著改善。严重的副作用仅限于1例出现热性惊厥的接受干扰素治疗的患者，停药后症状缓解。我们得出结论，包括干扰素和甲氨蝶呤在内的辅助治疗显然对呼吸道乳头状瘤病患者的治疗有益。本文介绍了一种结合干扰素给药方案的详细手术方法。甲氨蝶呤的进一步研究似乎是必要的。
