Intralesional cidofovir injection for recurrent respiratory papillomatosis in Japan

Auris Nasus Larynx. 2016 Oct;43(5):541-5. doi: 10.1016/j.anl.2016.01.005. Epub 2016 Feb 6.

Abstract

Objective: The treatment of recurrent respiratory papillomatosis (RRP) continues to be difficult. Adjuvant pharmacological treatment is increasingly being used, and intralesional cidofovir injection remains the leading option. Almost all papers regarding the treatment come from the United States and Europe. The present study demonstrated it for the first time from Asia.

Methods: Ten patients with RRP were treated with intralesional cidofovir injection. The severity of papillomatosis and adverse events including blood leukocytes, blood neutrophils, and serum creatinine were evaluated before and after the completion of treatment.

Results: Human papillomavirus (HPV) type 6 was detected in nine patients, and no types of HPV were detected in a remaining patient. Severity scores significantly improved after treatment (p=0.005). However, complete resolution was achieved in only one patient. No significant differences were observed between before and after treatment with respect to adverse events (p=0.866 for blood leukocytes, p=0.866 for blood neutrophils, and p=0.933 for serum creatinine). Squamous cell carcinoma occurred three and half years after the completion of treatment in a patient without HPV detection. However, the link between cidofovir and the occurrence of carcinoma in the case remains questionable.

Conclusion: This initial report of intralesional cidofovir injection for RRP from Asia demonstrated acceptable efficacy without obvious adverse events. However, the uncontrolled spread of this treatment should be avoided, and eighteen statements approved by the task force of the United States should be referred to while planning this treatment.

Keywords: Cidofovir; Intralesional injection; Recurrent respiratory papillomatosis.

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / therapeutic use*
  • Cidofovir
  • Cytosine / analogs & derivatives*
  • Cytosine / therapeutic use
  • Female
  • Human papillomavirus 6
  • Humans
  • Injections, Intralesional
  • Japan
  • Laryngeal Neoplasms / drug therapy*
  • Laryngeal Neoplasms / virology
  • Laryngoscopy
  • Male
  • Middle Aged
  • Organophosphonates / therapeutic use*
  • Papillomavirus Infections / drug therapy*
  • Papillomavirus Infections / virology
  • Respiratory Tract Infections / drug therapy*
  • Respiratory Tract Infections / virology
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult

Substances

  • Antiviral Agents
  • Organophosphonates
  • Cytosine
  • Cidofovir

Supplementary concepts

  • Recurrent respiratory papillomatosis