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Is intralesional cidofovir worthwhile in juvenile recurrent respiratory papillomatosis?

P Sheahan1, S Sexton, J D Russell

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland. sheahanp@eircom.net

The Journal of Laryngology and Otology
|July 13, 2006
PubMed

Insights

Intralesional cidofovir shows promise in managing recurrent respiratory papillomatosis (RRP) in children, reducing disease severity and controlling regrowth. However, it is less effective for complete eradication and prolonged treatment beyond eight injections may not be beneficial.

Area of Science:

  • Pediatric Otolaryngology
  • Viral Infections
  • Oncology

Background:

  • Recurrent respiratory papillomatosis (RRP) is a rare, chronic disease caused by human papillomavirus (HPV).
  • RRP poses significant challenges in pediatric management due to potential airway obstruction and frequent surgical interventions.

Purpose of the Study:

  • To evaluate the effectiveness of intralesional cidofovir as a treatment for RRP in pediatric patients.
  • To assess the impact of cidofovir on disease severity and papilloma regrowth.

Main Methods:

  • Prospective observational study involving four children with RRP.
  • Treatment included surgical debulking followed by intralesional cidofovir injections.
  • Disease severity was monitored using an anatomical RRP severity score and photodocumentation.

Main Results:

  • One patient achieved complete remission; two showed partial response.
  • Deterioration was observed when treatment was paused, with subsequent improvement upon resumption.
  • A plateau in efficacy was noted by the eighth cidofovir injection.

Conclusions:

  • Intralesional cidofovir can help control RRP and reduce disease severity in children.
  • Cidofovir appears less effective for complete disease eradication.
  • Evidence suggests limited benefit from prolonged treatment regimens exceeding eight injections.
Abstract

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