Efficacy of microsurgery in combined with topical-PDT in treating recurrent respiratory papillomatosis: compare JORRP with AORRP

Abstract

Background: Recurrent respiratory papillomatosis (RRP) remains a challenging and frustrating disease to treat.

Objective: To explore the efficacy of microsurgery in combined with Topical-PDT in treating recurrent respiratory papillomatosis.

Materials and methods: Fifty patients with RRP were treated with microsurgery in combined with Topical-PDT. Medical document of each patient was retrospectively reviewed. Detailed clinical information, metrics of clinical course, and current results were evaluated.

Results: Juvenile onset RRP (JORRP) might experience a more aggressive course than AORRP (adult onset RRP) with higher Derkay score (p < .01) and higher operation frequency per year (p < .01). Microsurgical excision combined with Topical-PDT every 25 days achieved “remission” of disease in 78% of patients, “clearance” of disease in 52%, and “Cured” in two patients. Each patient who achieved “remission” of disease, performed 6.82 ± 3.39 operations, and continued 8.93 ± 7.03 months of treatment duration. No statistically differences were found in these two aspects between JORRP and AORRP. A negative correlation between tracheotomy and the efficacy of microsurgery in combined with Topical-PDT was found (p = .025, Pearson’s r = –0.3).

Conclusions and significance: Microsurgery in combined with Topical-PDT might be a powerful method to treat RRP. Tracheotomy is a negative factor for this therapy.

背景：反复性呼吸道乳头状瘤病（RRP）仍然是一种相当难治且令人沮丧的疾病。

目的：探讨显微外科手术结合局部PDT治疗复发性呼吸道乳头状瘤的疗效。

材料和方法：50例RRP患者接受显微外科手术结合局部PDT治疗。回顾性审查了每位患者的医疗记录, 评估了详细的临床信息、临床病程指标和当前结果。

结果：少年发病RRP（JORRP）可能比成人发病RRP （AORRP）具有更急势的过程, Derkay评分更高（p <.01）, 每年的手术频率也更高（p <.01）。每25天进行显微手术切除联合局部-PDT, 在78％的患者中实现病情“缓解”, 52％的病情“清除”, 以及两名患者的“治愈”。每位达到疾病“缓解”状态的患者均进行了6.82 ± 3.33个月的手术, 并持续了8.93 ± 7.03个月的治疗时间。JORRP和AORRP在这两个方面均未发现统计学差异。气管切开术与显微外科手术结合局部PDT的效果呈负相关（p = .025, 相关系数r =–0.3）。

结论与意义：显微外科联合局部PDT可能是治疗RRP的有效方法。气管切开术是该疗法的负因素。

Keywords:

• Larynx
• papilloma
• recurrent respiratory papillomatosis
• topical-PDT
• microsurgery

Acknowledgments

We sincerely thank all the patients for their participation and support in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Project of Capital Medical Development Research Fund (No: Z161100000516193).