Rosen C A, Woodson G E, Thompson J W, Hengesteg A P, Bradlow H L
Department of Otolaryngology--Head and Neck Surgery, University of Pittsburgh Medical Center, Pennsylvania, USA.
Otolaryngol Head Neck Surg. 1998 Jun;118(6):810-5. doi: 10.1016/S0194-5998(98)70274-8.
We report the preliminary results of a phase I trial using indole-3-carbinol for the treatment of recurrent respiratory papillomatosis. Indole-3-carbinol is a chemical that is found in high concentrations in cruciferous vegetables and has been shown to alter the growth pattern of recurrent respiratory papillomatosis cell cultures and to be effective in an in vivo animal model of recurrent respiratory papillomatosis.
Eighteen patients were treated with oral indole-3-carbinol and had a minimum follow-up of 8 months and a mean follow-up of 14.6 months. All patients received indole-3-carbinol, and outcome measures included a change in papilloma growth rate and the need for surgery during treatment compared with before treatment. All patients had serial examinations with videoendoscopy to document papilloma location and growth rate.
Thirty-three percent (6 of 18) of the study patients had a cessation of their papilloma growth and have not required surgery since the start of the study. Six patients have had reduced papilloma growth rate, and 6 (33%) patients have shown no clinical response to indole-3-carbinol. Indole-3-carbinol affects the ratio of hydroxylation of estradiol; changes in the ratios of urinary 2-hydroxylation and 16-hydroxylation of estradiol caused by indole-3-carbinol correlated well with clinical response. No major complications or changes in the children's growth curve were noted.
The preliminary results of treating recurrent respiratory papillomatosis with indole-3-carbinol holds promise. Longer follow-up of this patient group and a blinded, controlled trial are required. We conclude that indole-3-carbinol appears to be safe and well tolerated and may be an efficacious treatment for recurrent respiratory papillomatosis.
我们报告了一项使用吲哚 - 3 - 甲醇治疗复发性呼吸道乳头状瘤病的I期试验的初步结果。吲哚 - 3 - 甲醇是一种在十字花科蔬菜中含量很高的化学物质，已被证明可改变复发性呼吸道乳头状瘤病细胞培养物的生长模式，并在复发性呼吸道乳头状瘤病的体内动物模型中有效。
18名患者接受口服吲哚 - 3 - 甲醇治疗，最短随访8个月，平均随访14.6个月。所有患者均接受吲哚 - 3 - 甲醇治疗，结果指标包括与治疗前相比乳头状瘤生长速率的变化以及治疗期间手术需求。所有患者均通过视频内镜进行系列检查，以记录乳头状瘤的位置和生长速率。
33%（18名中的6名）的研究患者乳头状瘤生长停止，自研究开始以来无需手术。6名患者乳头状瘤生长速率降低，6名（33%）患者对吲哚 - 3 - 甲醇无临床反应。吲哚 - 3 - 甲醇影响雌二醇的羟基化比例；吲哚 - 3 - 甲醇引起的尿中雌二醇2 - 羟基化和16 - 羟基化比例的变化与临床反应密切相关。未观察到重大并发症或儿童生长曲线的变化。
用吲哚 - 3 - 甲醇治疗复发性呼吸道乳头状瘤病的初步结果很有前景。需要对该患者组进行更长时间的随访以及一项盲法对照试验。我们得出结论，吲哚 - 3 - 甲醇似乎安全且耐受性良好，可能是复发性呼吸道乳头状瘤病的一种有效治疗方法。
