Voice-preserved therapy of laryngeal papilloma in children

儿童喉乳头状瘤的保音治疗

• 批准号: 7487457
• 负责人: ZHI WANG
• 金额: $ 27.27万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7487457
• 关键词: Abbreviations; Adult; Adverse effects; Affect; Aftercare; Animals; Benign; Benzanthracenes; Blood Vessels; Boston; Chastetree; Child; Childhood; Cicatrix; Clinical; Clinical Research; Clinical Trials; Combined Modality Therapy; Country; Cyclooxygenase Inhibitors; Diagnosis; Disease; Disease Management; Dyes; Effectiveness; Event; Excision; Functional disorder; Genital system; Growth; Human; Human Papillomavirus; Indole-3-Carbinol; Infection; Invasive; Laboratories; Larynx; Laser Surgery; Lasers; Lesion; Link; Low-Level Laser Therapy; Measurable; Medical center; Morbidity - disease rate; Nature; None or Not Applicable; Numbers; Operative Surgical Procedures; Otolaryngology; Outpatients; Papilloma; Patients; Photochemotherapy; Physiologic pulse; Postoperative Period; Procedures; Prostaglandin-Endoperoxide Synthase; Pulse taking; Recurrence; Research Personnel; Respiratory Papilloma; Role; Safety; Squamous Papilloma of the Larynx; Techniques; Testing; Time; Tissues; Toxic effect; Trauma; Treatment Efficacy; Tretinoin; United States; Vascular blood supply; Voice; Woman; Work; benzanthracene; cardiovascular risk factor; celecoxib; chemotherapy; concept; cost; cruciferous vegetable; cyclooxygenase 1; cyclooxygenase 2; day; density; desire; dietary supplements; diindolylmethane; innovative technologies; medical schools; prevent; psychologic; respiratory; success; tissue trauma; tumor; vocal cord

DESCRIPTION (provided by applicant): Respiratory recurrent papilloma (RRP) is the most common benign tumor occurring in children. This disease usually involves the vocal cords or other regions of the larynx, thereby, resulting in a poor voice. Surgical removal is the current management for RRP, but it is a very traumatic procedure. The surgery often produces vocal cord scarring and leads to permanent voice dysfunction. Additionally, this disease is difficult to be cured because of its strong tendency to recur. Thus, the traumatic surgery and postoperative recurrence probably are two the most challenging problems with current RRP treatment. Our previous studies have shown the efficacy and safety of a microvascular targeting technique (MVT) for RRP treatment using the 585 nm pulsed dye laser (PDL). This technique provides a less traumatic alternative to surgery. However, postoperative recurrence of lesions still remains a problem because of microvascular regrowth. This study is a continuation of our effort to develop a new and less traumatic treatment for this disease. In this study, we will determine a new and combined treatment of PDL and a dietary supplement (diindolylmethane, DIM), for children with RRP. Our hypothesis is that postoperative administration of DIM will provide a long-term inhibitory effect on RRP lesions, thereby delaying or preventing RRP from recurring after the PDL therapy. Our specific aim in this study is to determine long-term efficacy of DIM in preventing postoperative RRP recurrence, after PDL surgery. We also will determine the time course of the lesion recurrence and will conduct laboratory tests to identify treatment side-effect (if any) with DIM. We will compare this new combined strategy with PDL-only treatment, in 30 children with RRP (15 of each). This is the first time to combine this new laser MVT technique with DIM, for RRP treatment in children. This combined strategy, if successful in this proposed study, will provide a new and ideal "voice-preserving" RRP treatment that will result less trauma to vocal cords and deliver long-term treatment efficacy. It would be safe and convenient enough for an out-patient treatment.

描述（由申请人提供）：呼吸道复发性乳头状瘤（RRP）是儿童最常见的良性肿瘤。这种疾病通常涉及声带或喉部的其他区域，从而导致声音变差。手术切除是目前治疗RRP的方法，但这是一个非常创伤性的过程。手术经常会产生声带疤痕，并导致永久性的声音功能障碍。此外，这种疾病很难治愈，因为它有很强的复发倾向。因此，创伤性手术和术后复发可能是目前RRP治疗的两个最具挑战性的问题。我们之前的研究已经显示了使用585 nm脉冲染料激光（PDL）进行RRP治疗的微血管靶向技术（MVT）的有效性和安全性。这种技术提供了一种创伤较小的手术替代方案。然而，由于微血管再生，术后病变复发仍然是一个问题。这项研究是我们努力为这种疾病开发一种新的创伤性较小的治疗方法的继续。在这项研究中，我们将确定一种新的联合治疗PDL和膳食补充剂（二吲哚甲烷，DIM），与RRP的儿童。我们的假设是，术后给予DIM将对RRP病变产生长期抑制作用，从而延迟或预防PDL治疗后RRP复发。本研究的具体目的是确定PDL手术后DIM预防术后RRP复发的长期疗效。我们还将确定病变复发的时间进程，并将进行实验室检查，以确定DIM治疗的副作用（如果有的话）。我们将在30例RRP儿童（各15例）中比较这种新的联合策略与PDL单独治疗。这是第一次将这种新的激光MVT技术与DIM结合联合收割机，用于儿童RRP治疗。如果在这项拟议的研究中取得成功，这种联合策略将提供一种新的理想的“保留声音”RRP治疗，对声带的创伤较小，并提供长期的治疗效果。对于门诊治疗来说，这将是足够安全和方便的。