title: The use of the quadrivalent human papillomavirus vaccine (gardasil) as adjuvant therapy in the treatment of recurrent respiratory papilloma.
abstract: OBJECTIVE
  To examine the effect of the quadrivalent human papillomavirus vaccine, Gardasil, on the disease course of patients with recurrent respiratory papillomatosis (RRP).
  
  
  METHODS
  A retrospective chart review of patients with RRP was conducted and 20 patients were selected who had received the Gardasil vaccine as part of their treatment. Efficacy was assessed by calculating the intersurgical interval (ISI) before and after receiving the vaccine, as well as number of complete and partial remissions.
  
  
  RESULTS
  Analysis of all patients found a significant increase in the ISI of 3.1 months (95% confidence interval [CI]: 1.02-5.19, P=0.0061). Male patients experienced an increase in the ISI of 4.2 months (95% CI: 1.6-6.7, P=0.0048). Female patients had a nonsignificant increase in ISI of 1.2 months (95% CI: 3.1-5.4, P=0.51). Eight patients (40%; six male and two female) experienced complete remission. Five patients (25%) overall (three male and two female) experienced partial remission. In total, complete or partial remission was achieved in a total of 13 (65%) patients (nine male and four female).
  
  
  CONCLUSIONS
  The Gardasil vaccine can modulate the severity of RRP and induce remission in some patients. The effect was much greater in males and in females in low estrogen states.
authors.affiliation: College of Medicine, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: David L
authors.initials: DL
authors.lastname: Young
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Moore
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, MUSC Evelyn Trammell Institute for Voice & Swallowing, Medical University of South Carolina, Charleston, South Carolina; Department of Pediatrics, MUSC Evelyn Trammell Institute for Voice & Swallowing, Medical University of South Carolina, Charleston, South Carolina. Electronic address: halstead@musc.edu.
authors.forename: Lucinda A
authors.initials: LA
authors.lastname: Halstead
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000276:immunology*; D030361:Papillomavirus Infections / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D012074:Remission Induction; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18
keywords: Adjuvant therapy; Gardasil; Quadrivalent HPV vaccine; Recurrent respiratory papilloma; Treatment