Natural history of adult-onset laryngeal papillomatosis following multiple cidofovir injections.
OBJECTIVE
A prospective study was performed to assess the intermediate and long-term efficacy of intralesional cidofovir therapy associated with surgical excision in laryngeal papillomatosis in adults.


METHODS
Endoscopy with intralesional injection of cidofovir 5 mg/mL was performed 3 times at 4-week intervals. The concentration was later increased to 7.5 mg/mL and the interval between injections shortened to 2 weeks. Further treatment was performed at 3 or 6 months, depending on the evolution of the papillomas. After complete remission, the treatment was stopped and the patients were reviewed every 6 months.


RESULTS
Nineteen patients completed the protocol, with a mean of 4.5 injections each. Complete remission was obtained in 17 cases (89%) after a mean of 3.8 procedures. Remission was stable after a mean follow-up of 24 months (range, 8 to 57 months). With higher cidofovir concentrations at shorter intervals, patients needed fewer injections to achieve remission (mean, 2.1 versus 4.7 injections).


CONCLUSIONS
The effectiveness of intralesional cidofovir therapy in adult-onset recurrent respiratory papillomatosis was impressive. Once obtained, complete remission was stable on intermediate or long-term follow-up. The concentration and the interval between injections seemed to influence the number of injections necessary to achieve remission.
Department of Otolaryngology, Edouard Herriot University Hospital, Lyon, France.
Ana Nusa
AN
Naiman
Darius
D
Abedipour
Sonia
S
Ayari
Elizabeth
E
Fresnel
Bruno
B
Coulombeau
Jean-Baptiste
JB
Bour
Patrick
P
Froehlich
D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D001706:Biopsy; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D052163:Human papillomavirus 6 / Q000235:genetics; D006801:Humans; D015552:Injections, Intralesional; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000601:surgery / Q000821:virology; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage*; D010212:Papilloma / Q000188:drug therapy* / Q000601:surgery / Q000821:virology; D030361:Papillomavirus Infections / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000998:Antiviral Agents; D004279:DNA, Viral; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir