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A 10-Year Perspective

Neil Tanna, MD, MBA; Douglas Sidell, MD; Arjun S. Joshi, MD; Steven A. Bielamowicz, MD

Arch Otolaryngol Head Neck Surg. 2008;134(5):497-500.

Objective  To assess the long-term efficacy of intralesional cidofovir therapy in a previously reported cohort of adult subjects with laryngeal papilloma.

Design  Retrospective review.

Setting  Tertiary care medical center.

Patients  We previously reported on the favorable clinical response to intralesional cidofovir therapy in 13 adult subjects. The subjects were enrolled in an open-trial prospective study (1997-2001) and completed the injection-only treatment protocol, and all subjects achieved a disease remission after a mean of 6 injections. In the present study, we review the clinical course of these subjects during an extended observational period (2001-2006).

Intervention  Patients with documented relapse of disease underwent additional intralesional cidofovir injections.

Main Outcome Measures  Additional interventions, disease severity, and adverse outcomes are reported.

Results  Following the original cidofovir protocol, 6 patients (46%) received no further interventions. The remaining 7 patients (54%) required further treatment for disease relapse, with a mean duration of remission before relapse of 1.05 years. Of the 7 patients who experienced disease relapse, 2 continued to have stable disease with regular injections, 2 were lost to follow-up during relapse treatment, and 3 achieved disease remission again. For this latter cohort, the mean number of injections per year necessary to achieve a second remission was 3.82. This compares with a mean of 1.77 injections per year that these patients received on an as-needed basis prior to the original study.

Conclusion  Intralesional cidofovir injections have been shown to be an effective therapy for adult laryngeal papilloma and should be considered in those patients who experience disease relapse.

Author Affiliations: Voice Treatment Center and Division of Otolaryngology, The George Washington University, Washington, DC (Drs Tanna, Joshi, and Bielamowicz); and Division of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles (Dr Sidell).

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