Intralesional cidofovir for recurrent respiratory papillomatosis in children.

Abstract

OBJECTIVE:

To assess the potential benefit of intralesional administration of cidofovir, an acyclic nucleoside phosphonate with activity against several DNA viruses, for treating severe respiratory papillomas in pediatric patients.

DESIGN:

Prospective case series.

SETTING:

Tertiary care children's hospitals.

PATIENTS:

Five pediatric patients with severe recurrent respiratory papillomatosis requiring laryngoscopy with carbon dioxide laser therapy more frequently than once a month to maintain airway patency. Each patient underwent between 12 and 33 laryngoscopies with laser treatment prior to being injected with cidofovir.

INTERVENTION:

Microsuspension laryngoscopy with intralesional injection of cidofovir (Vistide) in conjunction with mechanical debulking and carbon dioxide laser of papillomas.

MAIN OUTCOME MEASURE:

Papilloma stage at time of serial laryngoscopies.

RESULTS:

One patient was disease free and 3 patients demonstrated a dramatic response to adjuvant therapy with cidofovir at the 9-month follow-up visit after the last injection of cidofovir. One patient showed an improvement in papilloma stage that was possibly related to concurrent therapy with interferon.

CONCLUSIONS:

Intralesional injection of cidofovir seems to be of benefit in the treatment of severe respiratory papillomatosis in pediatric patients. Larger prospective studies with longer follow-up will be required before cidofovir can be considered an accepted means of managing this difficult disease.

• Authors: S M Pransky, A E Magit, D B Kearns, D R Kang, N O Duncan
• Journal: Archives of otolaryngology--head & neck surgery (Arch Otolaryngol Head Neck Surg) Vol. 125 Issue 10 Pg. 1143-8 (Oct 1999) ISSN: 0886-4470 [Print] United States
• PMID: 10522508 (Publication Type: Journal Article)

Chemical References

• Antiviral Agents
• Organophosphonates
• Organophosphorus Compounds
• Cytosine
• Cidofovir

Topics

• Antiviral Agents (administration & dosage, therapeutic use)
• Child, Preschool
• Cidofovir
• Cytosine (administration & dosage, analogs & derivatives, therapeutic use)
• Female
• Humans
• Infant
• Injections, Intralesional
• Laryngeal Neoplasms (drug therapy)
• Male
• Organophosphonates
• Organophosphorus Compounds (administration & dosage, therapeutic use)
• Papilloma (drug therapy)
• Pilot Projects
• Prospective Studies
• Recurrence
• Treatment Outcome