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。
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.