• Title/Summary/Keyword: 재발성 호흡기 유두종증

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Prevention and Adjuvant Therapy of Recurrent Respiratory Papillomatosis (재발성 호흡기 유두종증의 예방과 보조 요법)

  • Lee, Dong Kun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.7-12
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    • 2020
  • Recurrent respiratory papillomatosis (RRP) is characterized by repeated recurrence in the respiratory system, such as the pharynx, larynx, and trachea, caused by the human papilloma virus. The main treatment is surgical removal of the papilloma. However repeated recurrence of RRP in multiple areas is burdened for the surgeon. In addition to the surgery, various adjuvant therapies have been studied to reduce the recurrence. Literature review was conducted with a focus on the adjuvant treatments for RRP.

Efficacy of Long-term Interferon-alpha Therapy in Adult Patients with Recurrent Respiratory Papillomatosis (성인의 재발성 호흡기계 유두종증 환자에서 장기간 인터페론 치료의 유효성)

  • Nam, Hae-Seong;Koh, Won-Jung;Suh, Gee Young;Chung, Man Pyo;Kwon, O Jung;Kim, Hojoong
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.5
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    • pp.390-395
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    • 2008
  • Background: Since the early 1980s, interferon-alpha ($IFN-{\alpha}$) has been used as adjuvant therapy in pediatric patients with recurrent respiratory papillomatosis (RRP). However, its efficacy in adults needs to be validated. Since 2002, Samsung Medical Center's guidelines have mandated regular injection of $IFN-{\alpha}$ in patients with RRP to prevent recurrence. To evaluate these guidelines, patient data were investigated. Methods: Five patients diagnosed as having RRP by bronchoscopy and histopathology were included. After initial bronchoscopic intervention, including laser cauterization, all patients received subcutaneous injection of 6 million units of $IFN-{\alpha}$ every 2 months. Further bronchoscopic intervention was carried out as needed. Patients were regularly evaluated using bronchoscopy or computed tomography. Results: The median age of the patients was 44 years (range 13~68), and the median duration of papillomatosis was 31 years (range 1~45). Three and two patients had juvenile-onset and adult-onset disease, respectively. Two patients had a history of tracheostomy at the time of diagnosis. The median duration of $IFN-{\alpha}$ therapy was 56 months (range 12~66). Two patients showed complete remission at 12 and 36 months after $IFN-{\alpha}$ injection, respectively. The other three patients showed partial remission, and the number of laser therapy sessions was significantly reduced.Conclusion: Intermittent $IFN-{\alpha}$ injection is effective in patients with long-standing RRP and can reduce the number of laser therapy sessions required in their treatment.

Clinical Significance of Recurrent Respiratory Papillomatosis

  • 남순열;박정제
    • Proceedings of the KSLP Conference
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    • 2003.11a
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    • pp.195-197
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    • 2003
  • 호흡기 유두종(recurrent respiratory papillomatosis, RRP)은 호흡기의 편평상피에 발생하는 바이러스성 질환으로 잦은 재발과 증식을 특징으로 한다. 다발성으로 발생하는 경우 소아에서는 생명을 위협하기도 하는 치명적인 질환이다. 호흡기 유두종의 발생에 가장 중요한 원인은 유두종 바이러스(human papilloma virus : HPV)의 감염으로 생각된다. HPV는 Papovaviridae군에 속하는 이중쇄 구조의 DNA virus로서 피부 사마귀, 항문성기기관 및 호흡소화기관의 양성 또는 악성 편평상피 유두종을 유발하는 원인 인자로 알려져 있다. 최근까지의 발표에 의하면 HPV 6, 11형이 호흡기 유두종증의 주원인이라고 알려져 있다. 원인 바이러스의 검출방법에 대하여 최근 DNA chip을 이용하는 방법이 개발되었고, 자궁경부암과 암 전구병변에서 인 유두종 바이러스의 아형에 대한 연구가 발표된 바 있다. (중략)

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Recurrent Respiratory Papillomatosis improved by Treatment with Interferon-${\alpha}$ (인터페론 치료로 호전을 보인 재발성 유두종증 1예)

  • Kim, Ki Uk;Cho, Woo Hyun;Jung, Kyung Sik;Park, Hye Kyung;Lee, Jun Hee;Lee, Joung Wook;Lee, Jung Hyun;Kim, Yun Seong;Lee, Min Ki;Wang, Soo Geun;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.346-352
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    • 2003
  • Recurrent respiratory papillomatosis(RRP) is a chronic disease that is caused by the human papillomavirus(HPV) type 6 and 11. The most common site of the lesions is the larynx, but papillomas can occur throughout the respiratory and upper gastrointestinal tracts. Frequent recurrence of disease, can result in airway compromise and even death when papillomas either obstruct the airway or spread to the lung parenchyma. We encountered a case of a recurrent respiratory papillomatosis in a 23-year-old patient, who improved after treatment with interferon-${\alpha}$ The patiented with hoarseness, exertional dyspnea, and a productive cough. We report this case with a brief review of the relevant literature.

Intralesional Cidofovir Therapy for Recurrent Repiratory Papillomatosis (재발성 호흡기 유두종증의 병변내 시도포비어 치료)

  • Song, Hyoung-Yong;Han, Myung-Woul;Choi, Seung-Ho;Kim, Sang-Yoon;Nam, Soon-Yuhl
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.2
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    • pp.136-140
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    • 2009
  • Background and Objectives: Recurrent respiratory papillomatosis (RRP) is difficult to treat because of its tendency to recur and spread throughout the aerodigestive tract. We aimed to estimate the effect of intralesional injections of cidofovir in patients with RRP. Materials and Method: Within the period from January 2003 to July 2007, 13 patients aged 2 to 61 years were treated with intralesional injections of cidofovir combined with surgical excision of RRP. Cidofovir was injected intralesionaly at a concentration of 5 mg/cc after complete removal of the papilloma with $CO_2$ laser or microdebrider. We evaluated the effect of intralesional cidofovir therapy by comparing pre-treatment mean interval of recurrence with post-treatment interval of recurrence. Results: Of 13 patients, two patients showed complete response during follow up period and four patients showed partial response. Seven patients did not respond to cidofovir at all. Mean pre-treatment mean interval of recurrence was 9 months and mean post-treatment interval of recurrence was 13.1 months (p=0.039). There was a statistical significance between the injected dose of cidofovir and post-treatment interval of recurrence (p=0.009). There were no local or systemic side effects caused by cidofovir. Conculsion : Intralesional injection of cidofovir seems to have a potential of a safe and effective adjuvant therapy of RRP. There was a positive correlation between the injected dose of cidofovir and patient clinical outcomes so that administration of higher doses and more frequency of injections should be needed to reduce recurrence. Further study regarding injection therapy regimen for RRP is required.

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