[Local application of cidofovir as adjuvant therapy in recurrent laryngeal papillomatosis in children].
OBJECTIVE
Evaluate the efficacy of local application of cidofovir in association with surgical treatment of recurrent laryngeal papillomatosis in children.


METHODS
Prospective.


METHODS
Fourteen patients, with an average age of 4.7 years and with two or more relapses after surgical treatment, were submitted to resection of the papillomas and injection of 22.5 mg of cidofovir (7.5 mg/ml) in the tissue where the lesions had been removed. After 2 to 3 week intervals, the same dose of cidofovir was repeated two or three times. In the case of relapse, a new cycle of surgery followed by local applications of cidofovir was repeated. Five children presented HPV-6 and five HPV-11, while in four, the type was not determined.


RESULTS
Before beginning of the study, patients were submitted, on the average, to 2 operations a year for control of relapses. After treatment with cidofovir, the annual rate for surgery dropped to 1.1 (p = 0.013). The average interval between relapses before beginning of the study was 1.4 months; at the end of the study, the interval reached 4.4 months (p = 0.014). Patients with HPV-6 did not show a significant change in the intervals between relapses after treatment with cidofovir, while 60% of the children with HPV-11 were disease free at the study end.


CONCLUSIONS
Cidofovir was found to be an effective adjuvant in the treatment of recurrent laryngeal papillomatosis in children, when used in the form of local applications in association with surgical resection of the lesions. HPV-11 may be more susceptible to the beneficial effects of cidofovir.
Pontes
Paulo
P
Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo, São Paulo, SP.
Weckx
Luc L M
LL
Pignatari
Shirley S N
SS
Fujita
Reginaldo R
RR
Avelino
Melissa A G
MA
Sato
Juliana
J
D000998:Antiviral Agents / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D052140:Human papillomavirus 11 / Q000187:drug effects; D052163:Human papillomavirus 6 / Q000187:drug effects; D006801:Humans; D007223:Infant; D015552:Injections, Intralesional; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000601:surgery / Q000821:virology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000517:prevention & control; D063065:Organophosphonates / Q000008:administration & dosage*; D010212:Papilloma / Q000188:drug therapy* / Q000601:surgery / Q000821:virology; D011446:Prospective Studies; D016896:Treatment Outcome
D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir