TREATMENT OF LARYNGOTRACHEAL PAPILLOMATOS IS WITH COMBINED USE OF LASER-SURGERY AND INTRALESIONAL APPLICATION OF ALPHA-INTERFERON (ROFERON(R))

Since the discovery of a viral aetiology (HPV 6 and 11), alpha-interfe ron (alpha-IFN) following surgical procedures has proved effective. In this article, we report on nine patients (four children, five adults) with laryngotracheal papillomatosis who received interstitial alpha-2 a-IFN injections (Roferon(R), 3 Mio. IU) into the laser surgical coagu lation area following laser excision of papilloma. The average duratio n of treatment is 29 months (Table 3). In all cases TFN therapy proved to respond with no initial failure. In five cases the treatment was f inished after a four-year period with no signs of tumour recurrence (T able 4). One patient (N., P. in Table 4) with excessive manifestations spread over pharynx, larynx and trachea achieved partial remission wi th definite control over the disease for (so far) 17 months. Two patie nts have remained free of disease for five and seven months (J., D. in Table 4 and Fig. 1 a-c) after initial therapy onset with complete rem ission. Another child (W., F. in Table 4) had a recurrence after compl ete remission for ten months and no observation period for eight month s. After recurrent IFN-application this patient has been tumour-free f or now six months. Apart from flu-like symptoms no side effects of int ralesional IFN-injections could be seen. The obtained results confirm that combined laser surgery and alpha-IFN treatment is the therapy of choice up to now. Since IFN is not a benign agent and systemic adminis tration bears potential side effects, adjuvant intralesional alpha-IFN is effective and safe and extends the therapeutical possibilities ava ilable in laryngotracheal papillomatosis.