Eicher S A, Taylor-Cooley L D, Donovan D T
Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Tex.
Arch Otolaryngol Head Neck Surg. 1994 Apr;120(4):405-9. doi: 10.1001/archotol.1994.01880280033005.
Retinoic acid has been advocated for use in several premalignant and malignant epithelial lesions of the head and neck, including benign recurrent respiratory papillomatosis, with varying results. We describe a 24-year-old man with extensive tracheoesophageal and bronchoalveolar papillomatosis that degenerated into squamous cell carcinoma. Multiple endoscopic carbon dioxide laser excisions, at one point performed on a weekly basis, as well as a prolonged trial of interferon, failed to control the progression of his disease. Isotretinoin (13-cis-retinoic acid) therapy (1 mg/kg per day) was instituted, with dramatic clinical, radiographic, and functional improvement. The patient experienced no significant toxic effects and required no endoscopic procedures over a 6-month period. We propose that isotretinoin may be an effective adjuvant therapy for aggressive respiratory papillomatosis.
维甲酸已被提倡用于治疗头颈部多种癌前和恶性上皮病变，包括良性复发性呼吸道乳头状瘤病，但其效果各异。我们描述了一名24岁男性，患有广泛的气管食管和支气管肺泡乳头状瘤病，该病已恶变为鳞状细胞癌。多次内镜下二氧化碳激光切除术（曾一度每周进行一次）以及长期使用干扰素治疗均未能控制其疾病进展。于是开始使用异维甲酸（13 - 顺式维甲酸）治疗（每日1毫克/千克），临床、影像学和功能方面均有显著改善。患者在6个月期间未出现明显的毒性反应，也无需进行内镜检查。我们认为异维甲酸可能是侵袭性呼吸道乳头状瘤病的一种有效辅助治疗方法。
