Medical Student Albert Einstein College of Medicine
Educational Objective: At the conclusion of this presentation, the participants should be able to identify HPV vaccine as an effective adjuvant therapy in the treatment of RRP.
Objectives: To characterize the efficacy of human papillomavirus (HPV) vaccination as adjuvant therapy in recurrent respiratory papillomatosis.
Study Design: Systematic review.
Methods: Articles published to April 2021 in PubMed, Embase, Cochrane, Google Scholar, ClinicalTrials.gov, and Web of Science were selected with the assistance of a librarian. Relevant articles were systematically reviewed for content and inclusion/exclusion criteria. All retrieved studies were independently analyzed by two reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement and using predefined criteria for inclusion and exclusion. All retrieved studies (n= 870) were reviewed by title and abstract and qualitatively assessed based on inclusion and exclusion criteria. Demographic data, vaccination status, surgical information, inter-surgical interval and surgical procedures per year were collected.
Results: The systematic review included 13 studies, comprising 240 patients. All studies utilized the Gardasil quadrivalent vaccine, and one study (Yiu et al. 2019) utilized both the quadrivalent and Gardasil 9 valent vaccines. 6 studies compared inter-surgical interval prior to and after vaccination, with 4 studies (66.7%) demonstrating a significantly greater inter-surgical interval after vaccination (P <0.05). 5 studies compared surgical procedures per year prior to and after vaccination, with 3 studies (60.0%) reporting significantly less procedures after vaccination (P <0.05). 2 studies reported on HPV seroconversion, with HPV seropositivity of 100% (n=27) prior to vaccination and 25.9% after vaccination (n=7).
Conclusions: Given the unpredictable clinical course, HPV vaccination may be beneficial as an adjuvant treatment in conjunction with surgery in patients with RRP.