Intralesional cidofovir for pediatric recurrent respiratory papillomatosis

Area of Science:

• Otolaryngology
• Pediatric Pulmonology
• Viral Diseases

Background:

• Recurrent respiratory papillomatosis (RRP) is a rare, chronic disease caused by human papillomavirus (HPV).
• RRP can lead to significant airway obstruction and morbidity in children.
• Current treatment primarily involves surgical debulking, which is often insufficient for long-term disease control.

Purpose of the Study:

• To compare the efficacy of combined surgical debulking and intralesional cidofovir injections versus surgical debulking alone in pediatric patients with RRP.
• To evaluate the safety and disease response in children with RRP treated with intralesional cidofovir.

Main Methods:

• Retrospective medical record review of seven children with RRP at a tertiary care children's hospital.
• Four subjects received combined surgical debulking and intralesional cidofovir injections every two months.
• Three control subjects received repeated surgical debulking only. Disease severity was assessed using intraoperative endoscopic photographs and papilloma staging scores.

Main Results:

• The cidofovir group demonstrated significantly lower final papilloma staging scores compared to the control group (P < .05).
• No significant differences were observed in within-group scores between initial and final assessments for either the cidofovir or control groups.
• The treatment with intralesional cidofovir was found to be safe in the studied pediatric population.

Conclusions:

• Intralesional cidofovir injection, combined with surgical debulking, represents a safe and effective treatment option for pediatric recurrent respiratory papillomatosis.
• Wider consideration of cidofovir for pediatric RRP treatment is warranted.
• Larger studies are needed to definitively establish the impact of cidofovir on RRP management.