Outcomes of bevacizumab and cidofovir treatment in HPV-associated recurrent respiratory papillomatosis – review of the literature.

Objective: Recurrent respiratory papillomatosis (RRP) is caused by types 6 and 11 human papilloma virus and occurs in both children and adults. It is characterized by proliferation of benign squamous cell papillomas within the aerodigestive tract. The problem with recurrent respiratory papillomatosis treatment is high recurrence of papilloma growth following surgical removal. Method: A literature review was carried out via surveys based on electronic data in public domains: MedLine (USA National Library of Medicine), PubMed and SciELO, using keywords such as: recurrent respiratory papillomatosis, adjuvant treatment, cidofovir, and bevacizumab. All types of papers written in English were included (cross-sectional, prospective and retrospective clinical trials, review papers, and case reports). Results: In the recent literature, several types of treatment such as surgery with mechanical debulking or laser and adjuvant therapies are mentioned. Intralesional bevacizumab and cidofovir treatment may increase the interval between surgical procedures and decrease the number of procedures per year. Conclusions: There is still an ongoing discussion within the European Laryngological Society regarding the balance between effectiveness and side effects of RRP adjuvant treatment, however, recent results show promising long-term effects. Bevacizumab and cidofovir in aggressive RRP give hope for improved treatment outcomes.