title: Adult recurrent respirator papillomatosis: a new therapeutic approach with pegylated interferon alpha 2a (Peg-IFNα-2a) and GM-CSF.
abstract: OBJECTIVE
  To determine a new therapeutic approach using granulocyte monocyte-colony-stimulating factor (GM-CSF) and pegylated interferon alpha 2a (Peg-IFNα-2a) as adjuvant therapy in patients with adult recurrent respiratory papillomatosis.
  
  
  METHODS
  Descriptive observational clinical trial.
  
  
  METHODS
  Departments of Otolaryngology and Immunology.
  
  
  METHODS
  Fourteen patients with adult recurrent respiratory papillomatosis were examined regarding medical history and number of operations before and after treatment. Voice disorder and glottal stop were evaluated using the Voice-Related Quality-of-Life instrument. Papilloma staging was determined using the Coltera/Derkay diagram. The patients received Peg-IFNα-2a at 180 mcg weekly for 6 months. In the third month, the patients began GM-CSF treatment at 400 mcg weekly for 2 months. The patients were observed for 12 months after treatment ended.
  
  
  RESULTS
  Eleven patients met the study criteria; 3 patients had tracheotomies before treatment, and they were decannulated after treatment. Before treatment, the scale of voice quality ranged from 34 to 45 points (mean, 38.31). After treatment, the range was 12 to 35 points (mean, 21.09; P < .001). Prior to therapy, the glottal stop ranged from 50% to 90% (average, 62.27%). After therapy, the range decreased to 0% to 15% (mean, 4.63%; P < .001). The number of surgical interventions decreased. Two patients each had 1 surgical intervention after treatment began.
  
  
  CONCLUSIONS
  A new adjuvant treatment based on immunogenetic mechanisms against human laryngeal papilloma virus, with expectations of reducing disease aggressiveness and the number of operations, avoids the risks of surgery.
  
  
  CONCLUSIONS
  Peg-IFNα-2a and GM-CSF is an adjuvant therapy for treating adult recurrent respiratory papillomatosis.
authors.affiliation: Medical Practice of Dr R. Engler ENT (Buchs SG), Daenikon-Zürich, Switzerland. teresumo@bluewin.ch
authors.forename: Teresita
authors.initials: T
authors.lastname: Suter-Montano
authors.forename: Efraim
authors.initials: E
authors.lastname: Montaño
authors.forename: Carmen
authors.initials: C
authors.lastname: Martínez
authors.forename: Teresita
authors.initials: T
authors.lastname: Plascencia
authors.forename: Mayra T
authors.initials: MT
authors.lastname: Sepulveda
authors.forename: Miguel
authors.initials: M
authors.lastname: Rodríguez
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000188:drug therapy*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011788:Quality of Life; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014833:Voice Quality
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; C100416:peginterferon alfa-2a