PRELIMINARY-RESULTS OF THE USE OF INDOLE-3-CARBINOL FOR RECURRENT RESPIRATORY PAPILLOMATOSIS

OBJECTIVE: We report the preliminary results of a phase I trial using indole-3-carbinol for the treatment of recurrent respiratory papilloma tosis, Indole-3-carbinol is a chemical that is found in high concentra tions in cruciferous vegetables and has been shown to alter the growth pattern of recurrent respiratory papillomatosis cell cultures and to be effective in an in vivo animal model of recurrent respiratory papil lomatosis. METHODS: Eighteen patients were treated with oral indole-3- carbinol and had a minimum follow-up of 8 months and a mean follow-up of 14.6 months, All patients received indole-3-carbinol, and outcome m easures included a change in papilloma growth rate and the need for su rgery during treatment compared with before treatment, All patients ha d serial examinations with videoendoscopy to document papilloma locati on and growth rate. RESULTS: Thirty-three percent (6 of 18) of the stu dy patients had a cessation of their papilloma growth and have not req uired surgery since the start of the study, Six patients have had redu ced papilloma growth rate, and 6 (33%) patients have shown no clinical response to indole-3-carbinol, Indole-3-carbinol affects the ratio of hydroxylation of estradiol; changes in the ratios of urinary 5-hydrox ylation and 16-hydroxylation of estradiol caused by indole-3-carbinol correlated well with clinical response. No major complications or chan ges in the children's growth curve were noted. CONCLUSIONS: The prelim inary results of treating recurrent respiratory papillomatosis with in dole-3-carbinol holds promise. Longer follow-up of this patient group and a blinded, controlled trial are required. We conclude that indole- 3-carbinol appears to be safe and well tolerated and may be an efficac ious treatment for recurrent respiratory papillomatosis.