title: Intermediate-term and long-term results after treatment by cidofovir and excision in juvenile laryngeal papillomatosis.
abstract: OBJECTIVE
  We assessed the intermediate-term and long-term efficacy of intralesional injection of cidofovir used with surgical excision in juvenile-onset recurrent respiratory papillomatosis.
  
  
  METHODS
  The protocol was revised during the study, from endoscopy at 4-week intervals with intralesional injection of cidofovir at 5 mg/mL, to a 2-week interval and a 7.5-mg/mL dosage. Partial surgical excision of hypertrophic papillomas was performed before the initiation of injection. Further injections at 4-week (or 2-week) intervals were performed until complete remission.
  
  
  RESULTS
  Sixteen patients received a mean 8.9 injections. Complete remission was obtained in 12 patients (75%) after a mean 7.2 endoscopic treatments. Remission was stable at a mean 33.6 months' follow-up. Five of these 12 patients received 5.2 injections and remained disease-free at a mean 39.3 months' follow-up. Seven of the 12 had 1 relapse; they needed complementary treatment to become disease-free, and remained so thereafter over a mean 27.3 months' follow-up. The other 4 of the 16 patients (25%) continued to present active disease.
  
  
  CONCLUSIONS
  Active endoscopic treatment until complete remission led to a higher-than-expected complete remission rate on intermediate-term to long-term follow-up, with or without relapse. Transient relapse was associated with a long delay in initiating cidofovir treatment.
authors.affiliation: Department of Otolaryngology, Edouard Herriot Hospital, Lyon, France.
authors.forename: Ana Nusa
authors.initials: AN
authors.lastname: Naiman
authors.forename: Sonia
authors.initials: S
authors.lastname: Ayari
authors.forename: Richard
authors.initials: R
authors.lastname: Nicollas
authors.forename: Guillaume
authors.initials: G
authors.lastname: Landry
authors.forename: Bruno
authors.initials: B
authors.lastname: Colombeau
authors.forename: Patrick
authors.initials: P
authors.lastname: Froehlich
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D000077404:Cidofovir; D003131:Combined Modality Therapy; D003596:Cytosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D007822:Laryngeal Neoplasms / Q000628:therapy* / Q000821:virology; D007828:Laryngoscopy; D008297:Male; D063065:Organophosphonates / Q000627:therapeutic use*; D010212:Papilloma / Q000628:therapy* / Q000821:virology; D030361:Papillomavirus Infections / Q000150:complications / Q000628:therapy; D011446:Prospective Studies; D055502:Secondary Prevention; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir