Endres D R, Bauman N M, Burke D, Smith R J
Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City.
Ann Otol Rhinol Laryngol. 1994 Apr;103(4 Pt 1):301-5. doi: 10.1177/000348949410300407.
Six patients with severe, recalcitrant, juvenile-onset recurrent respiratory papillomatosis were treated with 7 independent trials of acyclovir. In 2 trials, patients received acyclovir in place of interferon-alpha; the remaining 5 trials were in patients not otherwise receiving chemotherapy. Quantitative analysis of overall disease extent, laryngeal involvement, and degree of glottic obstruction for the 6 months prior to acyclovir administration and during acyclovir administration demonstrated a statistically significant decrease in all parameters evaluated in those patients who were otherwise unmediated. The 2 patients who discontinued interferon-alpha immediately prior to beginning acyclovir demonstrated worsening disease, consistent with the well-recognized rebound phenomenon associated with stopping interferon. This study suggests that acyclovir decreases the extent of respiratory papillomatosis in patients with recalcitrant disease. The beneficial effect of acyclovir appears to be insufficient to counteract the rebound of disease when interferon is stopped abruptly.
六名患有严重、顽固性幼年型复发性呼吸道乳头状瘤病的患者接受了7次独立的阿昔洛韦试验治疗。在2次试验中，患者接受阿昔洛韦替代α干扰素治疗；其余5次试验针对未接受其他化疗的患者。对阿昔洛韦给药前6个月和给药期间的总体疾病范围、喉部受累情况和声门梗阻程度进行定量分析，结果显示，在未接受其他治疗的患者中，所有评估参数均有统计学意义的下降。在开始使用阿昔洛韦之前立即停用α干扰素的2名患者病情恶化，这与停用干扰素相关的公认的反弹现象一致。本研究表明，阿昔洛韦可减轻顽固性疾病患者的呼吸道乳头状瘤病范围。当突然停用干扰素时，阿昔洛韦的有益作用似乎不足以抵消疾病的反弹。
