[Intralesional cidofovir injections for recurrent laryngeal papillomatosis: first results].
BACKGROUND
The treatment of recurrent laryngeal papillomatosis still presents an important therapeutic problem. This primarily benign disease of the larynx is caused by an infection with the human papilloma virus (HPV) and forms epithelial neoplastic papillomas. Therapy in larynx obstructing papillomatosis usually requires laser ablation. Cidofovir acts virustatically as an nucleosidanalogon. Currently pilot studies investigate the effectiveness of intralesional Cidofovir injection.


METHODS
The present study covers the period from October 2001 to March 2003. Seven patients, age of five to 70 years, were treated with intralesional injections of Cidofovir after microlaryngoscopic ablation of laryngeal papillomas. In all patients papillomatosis was confirmed histologically and a clinical-phoniatric examination and a photo documentation pre- and postoperatively was carried out. We treated patients to a maximum of six sessions.


CONCLUSIONS
After three to six sessions of laser ablation of the papillomas and intralesional injections with Cidofovir a distinct papilloma reduction could be observed in all patients and in two cases a complete remission was achieved. The follow-up period of seven to 15 months revealed no recurrent laryngeal papillomatosis. The majority of patients showed a defined voice improvement. There were no local or systemic side-effects caused by the virustatic drug. Intralesional injection of Cidofovir appears to develop into a promising adjuvant therapy option in recurrent laryngeal papillomatosis. First results of the study seem to achieve a considerable reduction of the previously high rate of recurrence of laryngeal papillomatosis.
Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie Martin-Luther-Universität Halle-Wittenberg. kerstin.neumann@medizin.uni-halle.de
K
K
Neumann
A
A
Pudszuhn
C
C
Welzel
S
S
Bartel-Friedrich
M
M
Passmann
D000293:Adolescent; D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000188:drug therapy / Q000473:pathology; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D000077404:Cidofovir; D003131:Combined Modality Therapy; D003596:Cytosine / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007181:Inclusion Bodies, Viral / Q000187:drug effects / Q000648:ultrastructure; D015552:Injections, Intralesional; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D007830:Larynx / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D053685:Laser Therapy; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D010212:Papilloma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome
D000998:Antiviral Agents; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D003596:Cytosine; D000077404:Cidofovir