title: Intralesional cidofovir injection for recurrent respiratory papillomatosis in Japan.
abstract: OBJECTIVE
  The treatment of recurrent respiratory papillomatosis (RRP) continues to be difficult. Adjuvant pharmacological treatment is increasingly being used, and intralesional cidofovir injection remains the leading option. Almost all papers regarding the treatment come from the United States and Europe. The present study demonstrated it for the first time from Asia.
  
  
  METHODS
  Ten patients with RRP were treated with intralesional cidofovir injection. The severity of papillomatosis and adverse events including blood leukocytes, blood neutrophils, and serum creatinine were evaluated before and after the completion of treatment.
  
  
  RESULTS
  Human papillomavirus (HPV) type 6 was detected in nine patients, and no types of HPV were detected in a remaining patient. Severity scores significantly improved after treatment (p=0.005). However, complete resolution was achieved in only one patient. No significant differences were observed between before and after treatment with respect to adverse events (p=0.866 for blood leukocytes, p=0.866 for blood neutrophils, and p=0.933 for serum creatinine). Squamous cell carcinoma occurred three and half years after the completion of treatment in a patient without HPV detection. However, the link between cidofovir and the occurrence of carcinoma in the case remains questionable.
  
  
  CONCLUSIONS
  This initial report of intralesional cidofovir injection for RRP from Asia demonstrated acceptable efficacy without obvious adverse events. However, the uncontrolled spread of this treatment should be avoided, and eighteen statements approved by the task force of the United States should be referred to while planning this treatment.
authors: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Japan. Electronic address: murono@med.kanazawa-u.ac.jp.
authors: Shigeyuki
authors: S
authors: Murono
authors: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Japan.
authors: Yosuke
authors: Y
authors: Nakanishi
authors: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Japan.
authors: Akira
authors: A
authors: Tsuji
authors: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Japan.
authors: Kazuhira
authors: K
authors: Endo
authors: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Japan.
authors: Satoru
authors: S
authors: Kondo
authors: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Japan.
authors: Naohiro
authors: N
authors: Wakisaka
authors: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Japan.
authors: Tomokazu
authors: T
authors: Yoshizaki
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D000077404:Cidofovir; D003596:Cytosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D052163:Human papillomavirus 6; D006801:Humans; D015552:Injections, Intralesional; D007564:Japan; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000821:virology; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use*; D030361:Papillomavirus Infections / Q000188:drug therapy* / Q000821:virology; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000821:virology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir
keywords: Cidofovir; Intralesional injection; Recurrent respiratory papillomatosis