Intralesional cidofovir for recurrent respiratory papillomatosis in children

Seth M. Pransky, Anthony E. Magit, Donald B. Keams, D. Richard Kcing, Newton Duncan

Research output: Contribution to journalArticle

120 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1143-1148
Number of pages6
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume125
Issue number10
DOIs
StatePublished - Jan 1 1999

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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