评估局部注射贝伐单抗治疗复发性呼吸道乳头状瘤病的疗效和安全性：系统综述。

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2024-10-18 DOI:10.1016/j.ijporl.2024.112138

Hannah Walter , Mihiar Atfeh

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引用次数: 0

摘要

目的：复发性呼吸道乳头状瘤病（RRP）是一项临床挑战，通常需要采取多种干预措施来帮助缓解疾病复发或气道阻塞。在 RRP 的治疗方面，专家们提倡多种治疗策略。然而，成功率和疾病进展仍然存在很大差异。贝伐单抗是一种血管内皮生长因子（VEGF）单克隆抗体，它是一种很有前景的治疗方法，最初是通过全身使用。最近，局部注射贝伐单抗已成为治疗 RRP 的最新手段之一。本研究的目的是系统回顾有关鞘内注射贝伐单抗治疗 RRP 的有效性、适用性和用法的文献：方法：在 MEDLINE、Embase、Journals@Ovid 和 PubMed 上进行了系统检索。本研究报告遵循 PRISMA 指南。研究质量和偏倚风险采用纽卡斯尔-渥太华量表（NOS）进行评估：共有 6 项研究符合我们的纳入和排除标准，其中包括一项随机双盲安慰剂对照试验研究、一项病例系列研究、三项前瞻性研究和一项回顾性研究，共涉及 108 名患者。对解剖学、功能和客观结果进行了介绍和仔细研究。根据报告，34/38（89%）名患者在接受鞘内贝伐单抗治疗后病情完全缓解或复发率极低。然而，所有研究的结果衡量标准并不一致，因此很难进行直接比较。在 6 项研究中，2 项（33%）被认为质量较差，4 项（66%）被认为质量一般。没有关于鞘内注射贝伐珠单抗不良反应的报道：本研究结果表明，从客观和功能上看，鞘内注射贝伐珠单抗在 RRP 的治疗中具有潜在作用。还需要进一步的研究来加强证据基础，同时密切关注剂量优化、长期副作用评估和较轻疾病表型的管理。

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Evaluating the efficacy and safety of intralesional bevacizumab in the treatment of recurrent respiratory papillomatosis: A systematic review

Purpose

Recurrent respiratory papillomatosis (RRP) represents a clinical challenge, often necessitating multiple interventions to help mitigate against disease recurrence or airway obstruction. Multiple management strategies have been advocated by specialists regarding the management of RRP. However, the success rates and disease progression still vary widely. One promising treatment is bevacizumab, a vascular endothelial growth factor (VEGF) monoclonal antibody, which had been initially introduced systemically. More recently, intralesional bevacizumab has become one of the newest arms in dealing with RRP.

The aim of this study is to systematically review the literature on the effectiveness, applicability and usage of intralesional bevacizumab in the treatment of RRP.

Methods

A systematic search was carried out on MEDLINE, Embase, Journals@Ovid and PubMed. PRISMA guidelines were adhered to in the reporting of this study. Study quality and bias risk was assessed using the Newcastle-Ottawa Scale (NOS).

Results

6 studies have met our inclusion and exclusion criteria, one randomised doubled blinded placebo-controlled pilot study, one case series, three prospective and one retrospective study, encompassing a total of 108 patients. Anatomical, functional and objective outcomes are presented and scrutinised. Where reported, complete remission or minimal recurrence was identified in 34/38 (89 %) patients following treatment with intralesional bevacizumab. However, outcome measures were not consistent across all studies making it difficult to draw direct comparisons. Of the 6 studies, 2 (33 %) were deemed poor quality and 4 (66 %) fair quality. No adverse effects of intralesional bevacizumab were reported.

Conclusions

This study's findings suggest a potential role for intralesional bevacizumab in the management of RRP objectively and functionally. Further research is required to necessitate a stronger evidence base, paying close attention to dose optimisation, assessment of long-term side effects and management of less severe disease phenotypes.

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.