title: Recurrent respiratory papillomatosis by HPV: review of the literature and update on the use of cidofovir.
abstract: Recurrent respiratory papillomatosis is a viral induced disease characterised by exophytic epithelial lesions affecting the larynx. The problem with its treatment is the high recurrence of papilloma growth after surgical removal. The aim of our review is to analyse the actual use of cidofovir, an agent used in adjuvant therapy. We have reviewed 6 manuscripts that included a total of 118 patients. The parameters taken into account were: concentration of infiltrated cidofovir (mg/ml), therapeutic response, relapse-free time (months), side effects, genotypes (HPV-6/11/18) and evolution of dysplasia. Cidofovir was injected at concentrations from 2.5 to 15 mg/ml, therapeutic response was from 56.25% to 82.3% and relapse-free time was from 10.05 to 49 months. There were 2 cases of dysplasia during therapy. Ten patients had been infected by HPV-6, 4 patients by HPV-11 and 10 patients by HPV-6 and HPV-11. The purposes of our review include the following: to stress that the juvenile form is more aggressive than other forms, to demonstrate than the drug has good adjuvant action although it does not significantly change the final response to the disease, to show that side effects are modest and, finally, to disprove the hypothesis that cidofovir may promote evolution towards dysplasia. In conclusion, combination of surgical removal and injection of cidofovir is associated with good response in recurrent respiratory papillomatosis.
authors.affiliation: Department of Sensory Organs, Sapienza Università di Roma, Italy;
authors.forename: M
authors.initials: M
authors.lastname: Fusconi
authors.affiliation: Department of Sensory Organs, Sapienza Università di Roma, Italy;
authors.forename: M
authors.initials: M
authors.lastname: Grasso
authors.affiliation: Department of Sensory Organs, Sapienza Università di Roma, Italy;
authors.forename: A
authors.initials: A
authors.lastname: Greco
authors.affiliation: Department of Surgical Biotechnologies and Science, ENT Section, Sapienza Università di Roma, Italy;
authors.forename: A
authors.initials: A
authors.lastname: Gallo
authors.affiliation: Department of Sensory Organs, Sapienza Università di Roma, Italy;
authors.forename: F
authors.initials: F
authors.lastname: Campo
authors.affiliation: Department of ORL, Head & Neck Surgery, University of Louvain at Mont-Godinne, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Remacle
authors.affiliation: Department of Sensory Organs, Sapienza Università di Roma, Italy;
authors.forename: R
authors.initials: R
authors.lastname: Turchetta
authors.affiliation: Department of Surgical Biotechnologies and Science, ENT Section, Sapienza Università di Roma, Italy;
authors.forename: G
authors.initials: G
authors.lastname: Pagliuca
authors.affiliation: Department of Sensory Organs, Sapienza Università di Roma, Italy;
authors.forename: M
authors.initials: M
authors.lastname: DE Vincentiis
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D000077404:Cidofovir; D003596:Cytosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D063065:Organophosphonates / Q000627:therapeutic use*; D030361:Papillomavirus Infections / Q000188:drug therapy*; D012141:Respiratory Tract Infections / Q000188:drug therapy*
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir
keywords: Cidofovir; Larynx; Recurrent respiratory papillomatosis