Patient Perspectives on Systemic Bevacizumab Treatment for Recurrent Respiratory Papillomatosis

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2026-07-20 DOI:10.1002/lio2.70500

Sarah Gao, Jada Jones, Vasiliki Triantafillou, Lee M. Akst, Alexander T. Hillel, Kevin M. Motz, Adam M. Klein, Simon R. Best

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Abstract

Objectives

Systemic bevacizumab has been shown to reduce the surgical burden of recurrent respiratory papillomatosis (RRP). However, no previous studies have examined specific patient-reported differences in quality-of-life (QoL) between systemic bevacizumab and surgical treatment. This study aimed to assess patient perspectives across two academic medical centers to inform clinical practice and shared decision-making.

Methods

A cross-institutional survey was distributed to patients who previously underwent both systemic bevacizumab and surgical treatment for RRP. Participants rated their experiences with each treatment across four domains: QoL, adverse effects, economics, and mental health. Paired responses were compared using the Wilcoxon signed-rank test.

Results

Of 24 patients (mean age 48.3 years) who completed the survey, 18 (75%) were actively receiving systemic bevacizumab treatment. Mean age at RRP diagnosis was 17.1 years, and patients had undergone an average of 91.4 surgeries and 25.1 bevacizumab infusions. Compared with surgery, bevacizumab was associated with significantly improved self-reported voice (p < 0.001), breathing (p < 0.001), and swallowing (p < 0.001), with longer-lasting vocal improvement (p = 0.031), lower pain (p < 0.001), shorter vocal rest (p < 0.001), and fewer side effects (p = 0.002) with each treatment. Although expenditure (p = 0.649) and travel time (p = 0.288) did not differ significantly, patients reported missing fewer days of work (p < 0.001) during bevacizumab infusions. Moreover, optimism (p < 0.001) was greater with decreased fear (p = 0.002) during bevacizumab therapy. Overall, 79% wished to continue receiving bevacizumab treatment, and 83% believed it offered a better QoL.

Conclusion

Systemic bevacizumab improves patient QoL across multiple domains compared with surgical treatment and represents an important step toward more patient-centered care in RRP.

Level of Evidence

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系统性贝伐单抗治疗复发性呼吸道乳头状瘤病的患者观点

目的：全身贝伐单抗已被证明可以减少复发性呼吸道乳头状瘤病（RRP）的手术负担。然而，以前没有研究检查过患者报告的全身贝伐单抗和手术治疗在生活质量（QoL）方面的具体差异。本研究旨在评估两个学术医疗中心的患者观点，为临床实践和共同决策提供信息。方法：对既往接受全身贝伐单抗和手术治疗的RRP患者进行跨机构调查。参与者从四个方面评价了他们在每种治疗中的经历：生活质量、不良反应、经济和心理健康。配对反应采用Wilcoxon符号秩检验进行比较。结果：在完成调查的24例患者（平均年龄48.3岁）中，18例（75%）积极接受全身贝伐单抗治疗。RRP诊断时的平均年龄为17.1岁，患者平均接受了91.4次手术和25.1次贝伐单抗输注。与手术相比，每次治疗贝伐单抗均显著改善自我报告的声音（p p p = 0.031），降低疼痛（p p p = 0.002）。尽管支出（p = 0.649）和旅行时间（p = 0.288）没有显著差异，但患者报告在贝伐单抗治疗期间缺课天数更少（p = 0.002）。总的来说，79%的人希望继续接受贝伐单抗治疗，83%的人认为它提供了更好的生活质量。结论：与手术治疗相比，全身性贝伐单抗改善了患者在多个领域的生活质量，是RRP中朝着更加以患者为中心的护理迈出的重要一步。证据等级：4。

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