Intralesional cidofovir in severe juvenile respiratory papillomatosis

B-ENT. 2012;8(3):197-202.


Recurrent respiratory papillomatosis causes significant morbidity among affected children and usually requires frequent surgeries. We present a prospective case series including nine children at a Mexican tertiary referral center. All enrolled patients had severe disease that had required at least four surgical procedures, with a median of 6. Two children had tracheobronchial involvement, one had lung parenchymal disease, and one had a tracheostomy performed during his first surgery.

Objective: To assess the efficacy of intralesional cidofovir in lowering the surgery rate.

Study design: Prospective case series.

Setting: Tertiary referral center in Mexico City.

Methods: Nine Mexican children with severe disease were enrolled. Intralesional cidofovir was applied after surgical debulking at a concentration of 5 mg/mL with a four to six week interval.

Results: Six of the nine patients had a notable decrease in the rate of surgeries, with three patients remaining disease-free with follow up ranging from 1.8 to 3.3 years. No patient demonstrated laboratory abnormalities. Two patients showed moderate and mild dysplasia on papilloma biopsy distinguished by a lack of epithelial maturation with no mitoses or cellular atypia. Two patients died several months after the last injection.

Conclusions: Intralesional cidofovir appears to be effective in the treatment of recurrent respiratory papillomatosis, although further studies are required to determine its safety.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Child
  • Child, Preschool
  • Cidofovir
  • Cytosine / administration & dosage
  • Cytosine / analogs & derivatives*
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Injections, Intralesional
  • Laryngeal Neoplasms / diagnosis
  • Laryngeal Neoplasms / drug therapy*
  • Male
  • Neoplasm Staging
  • Organophosphonates / administration & dosage*
  • Papilloma / diagnosis
  • Papilloma / drug therapy*
  • Prospective Studies
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome


  • Antineoplastic Agents
  • Organophosphonates
  • Cytosine
  • Cidofovir