From the Guidelines
Vaccination is useful in patients with laryngeal recurrent respiratory papillomatosis (RRP), particularly those aged 9-26 years, as it may help prevent new lesions from forming and reduce recurrence rates after surgical removal. The HPV quadrivalent vaccine (Gardasil) or the 9-valent vaccine (Gardasil 9) is recommended for patients with laryngeal RRP, as they cover the HPV types 6 and 11 that are typically associated with this condition 1. The standard vaccination schedule involves three doses given over 6 months (0,2, and 6 months).
Some key points to consider when vaccinating patients with laryngeal RRP include:
- The vaccine has a good safety profile, with most side effects being mild and transient, such as pain at the injection site, headache, or low-grade fever 1.
- Vaccination-induced partial or complete remission has been reported in a substantial proportion of RRP patients, with no remarkable adverse effects 1.
- The rationale behind vaccination is that laryngeal RRP is caused by human papillomavirus (HPV) infection, and generating an immune response against these HPV types may help control the disease 1.
- Some studies suggest that vaccination may decrease disease severity, extend the time between surgical interventions, and potentially lead to disease remission in some patients 1.
It is essential to note that while vaccination does not cure existing RRP lesions, it may help prevent new lesions from forming and reduce recurrence rates after surgical removal 1. Therefore, vaccination is a useful adjunctive treatment for patients with laryngeal RRP, particularly those aged 9-26 years, and should be considered as part of a comprehensive treatment plan.
From the Research
Vaccination in Laryngeal RRP
- The human papillomavirus (HPV) vaccine has been shown to be effective in treating recurrent respiratory papillomatosis (RRP) by preventing new papilloma formation at additional sites 2.
- A case study found that HPV vaccination induced spontaneous regression of disease in a patient with RRP, with reduced tumor burden and improved voice quality after vaccination 3.
- Another study found that HPV vaccination in combination with surgical resection could suppress recurrence for an extended period of time in patients with RRP, with a significant decrease in the severity score of laryngeal disease and tumor incidence rate 4.
- A combined approach of surgery, intralesional injection of bevacizumab, and HPV vaccination has also been shown to be effective in resolving RRP, with all 5 patients in the study achieving a complete response 5.
- The use of HPV vaccination in the management of RRP has been highlighted as a potential therapeutic option, with the need for further evaluation of its efficacy in the adjuvant setting 6.
Key Findings
- HPV vaccination can induce spontaneous regression of disease in patients with RRP 3.
- HPV vaccination can prevent new papilloma formation at additional sites, reducing the need for frequent surgeries 2.
- The combination of HPV vaccination and surgical resection can suppress recurrence for an extended period of time in patients with RRP 4.
- A combined approach of surgery, intralesional injection of bevacizumab, and HPV vaccination can resolve RRP 5.
- Further research is needed to evaluate the therapeutic efficacy of HPV vaccination in the management of RRP 6.