Clinical Findings of Recurrent Respiratory Papillomatosis and Preliminary Results of the Adjuvant Therapy

Sung, Myung Whun; Choi, Byung Yoon; Jin, Jung Wook; Seong, Won Jin; Park, Bum Jung; Roh, Jong Lyel; Kim, Dae Woo; Won, Tae Bin; Kim, Kwang Hyun

Abstract

BACKGROUND AND OBJECTIVES: Recurrent respiratory papillomatosis (RRP) is difficult to treat because of its tendency to recur and spread throughout the respiratory tract. RRP is usually divided into two groups by age of onset. We aimed to investigate the different clinical courses between the childhood-onset and the adult-onset RRP and review the effects of the treatments. MATERIAL AND METHOD: We retrospectively reviewed 44 patients with RRP who had been treated in our hospital over the last 13 years. We compared the clinical courses and intersurgical intervals of childhood-onset RRP with those of adult-type and evaluated the effect of the alpha-interferon (local injection) by comparing preadjuvant average surgical interval with postadjuvant surgical interval with a review of the literature.
RESULTS
Childhood-onset RRP was most often diagnosed between 1 and 4 years of age. It was more widespread and it recurred more frequently than adult-onset RRP, often involving the trachea and necessitating the tracheostomy. Therefore, more frequent surgical interventions were needed in childhood-onset RRP (2.81/year) than in the adult-type (1.14/year). Adjuvant therapy (local injection of alpha-interferon) was applied to 10 patients. Seventy-five percent of the 8 patients (2 were excluded due to short duration of F/U period) showed complete response (CR) or partial resopnse (PR) and only two patients did not respond to alpha-interferon at all.
CONCLUSION
Childhood-onset RRP is more aggressive and widespread than its adult counterpart and intralesional injection of alpha-interferon seems to have a potential of a safe and effective adjuvant therapy for RRP.