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Adjuvant treatments for recurrent respiratory papillomatosis: a descriptive review and proposed management guideline in adults

Published online by Cambridge University Press:  21 October 2024

Edward Balai Open the ORCID record for Edward Balai [Opens in a new window] ,
Emilie AC Dronkers Open the ORCID record for Emilie AC Dronkers [Opens in a new window] ,
Chadwan A Yaghchi ,
Dorothy Gujral ,
Guri Sandhu  and
Aphrodite Iacovidou
Edward Balai*
Affiliation:
Department of Otolaryngology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
Emilie AC Dronkers
Affiliation:
National Centre for Airway Reconstruction, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
Chadwan A Yaghchi
Affiliation:
National Centre for Airway Reconstruction, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
Dorothy Gujral
Affiliation:
Department of Surgery and Cancer, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
Guri Sandhu
Affiliation:
National Centre for Airway Reconstruction, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
Aphrodite Iacovidou
Affiliation:
National Centre for Airway Reconstruction, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
*
Corresponding author: Edward Balai; Email: edward.balai@nhs.net
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Abstract

Objective

Recurrent respiratory papillomatosis is a rare disease characterised by growth of papilloma within the respiratory tract. The disease course is variable but can require frequent surgical interventions alongside adjuvant medical treatments. There is no definitive curative treatment or gold-standard guidelines for management. We aimed to evaluate current and potential future adjuvant treatments and propose a management guideline for adult patients.

Methods

Relevant articles were identified through searching databases, reference lists and grey literature.

Results

Systemic bevacizumab appears to be the most effective adjuvant treatment currently available. However, intralesional cidofovir also achieves a high complete-response rate in adults and the Gardasil vaccine demonstrates preventative and therapeutic value. The INO-3107 DNA vaccine is a promising potential future adjuvant treatment.

Conclusions

This review provides a detailed examination of current and potential future adjuvant treatments. Based on the literature, we have developed a management guideline for adult patients with recurrent respiratory papillomatosis.

Keywords

larynxendoscopylaserdysphoniatracheapapillomatosis

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 12 , December 2024 , pp. 1133 - 1143
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Edward Balai takes responsibility for the integrity of the content of the paper

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