Intralesional cidofovir therapy for laryngeal papilloma in an adult cohort
Intralesional cidofovir therapy for laryngeal papilloma in an adult cohort
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DOI：
10.1097/00005537-200204000-00019
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发表时间：
2002-04-01
期刊：
影响因子：
2.6
通讯作者：
Wilson, WR
中科院分区：
文献类型：
--
作者：
Bielamowicz, S;Villagomez, V;Wilson, WR
目标.证实西多福韦治疗喉乳头状瘤的安全性和有效性，并确定与达到缓解所需注射次数相关的变量。研究设计：一项开放性前瞻性试验，评价西多福韦治疗喉乳头状瘤的疗效。方法：14例经活检证实的成人喉乳头状瘤患者参加了一项病灶内注射西多福韦的治疗研究。方案前疾病持续时间范围为1 - 30年，平均持续时间为7年。受试者每月接受西多福韦注射，最大剂量为每次注射37.5 mg，溶于6 cc盐水（6.25 mg/mL）。重复注射，直到术中评估期间目视检查无乳头状瘤。达到疾病缓解后，受试者接受额外注射。所有注射均发生在支撑显微喉镜检查期间。结果：所有受试者均使用仅注射治疗方案实现了疾病缓解。未发现其他喉瘢痕形成或全身毒性。平均需要6次注射才能达到缓解。治疗前疾病持续时间和解剖学分期与疾病缓解所需的注射次数呈正相关。结论：病灶内注射西多福韦是一种很好的治疗选择，局部和全身毒性有限。注射治疗方案需要患者和外科医生的毅力。成人喉乳头状瘤可获得缓解。
Objectives. To confirm the safety and efficacy of intralesional cidofovir in the management of laryngeal papilloma and to identify variables that correlate with number of injections needed to achieve remission. Study Design: An open-trial prospective evaluation of the efficacy of intralesional cidofovir in subjects with laryngeal papilloma. Methods: Fourteen adult subjects with biopsy-proven laryngeal papilloma were enrolled in a treatment study of intralesional cidofovir. Preprotocol disease duration ranged from 1 to 30 years with a mean duration of 7 years. Subjects received monthly injections of cidofovir with a maximum dose of 37.5 mg per injection in 6 cc saline (6.25 mg/mL). Injections were repeated until no papilloma could be visually identified during an intraoperative evaluation. After disease remission was achieved, subjects received an additional injection. All injections occurred during suspension microlaryngoscopy. Results: All subjects have achieved disease remission using an injection-only treatment protocol. No additional laryngeal scarring or systemic toxicity was identified. On average, 6 injections were required to achieve remission. Preprotocol disease duration and anatomical staging correlated positively with the number of injections required for disease remission. Conclusions: Intralesional injection of cidofovir is an excellent treatment option with limited local and systemic toxicities. The injection therapy regimen requires perseverance from both patient and surgeon. Remission of disease can be achieved in adults with laryngeal papilloma.