The Differences In Efficacy Between Human Papillomavirus Vaccine And Intralesional Cidofovir In Patients With Recurrent Respiratory Tract Papilloma Based On Derkay Score, Interval And Number Of Operations (Meta-Analysis)
DOI:
https://doi.org/10.64252/yevgmc40Keywords:
respiratory papillomatosis, HPV, vaccine, cidofovir, Derkay score, human and health disease.Abstract
Introduction: Several adjuvant therapies have been used after surgery to reduce the recurrence in recurrent respiratory tract papilloma (RRP). To date, there is no adjuvant therapy that is consistently effective in reducing RRP recurrence. The older adjuvant therapy is intralesional cidofovir, and the newer is the HPV vaccine. The Derkay score is used to assess the clinical and therapeutic response of RRP. Lengthening of the operative interval and decreasing the number of surgeries are indicators of successful RRP adjuvant therapy.
Objective: Proving the efficacy of the HPV vaccine in patients with RRP compared to intralesional cidofovir based on the Derkay score, surgery interval, and number of surgeries.
Method: The meta-analysis study used the electronic databases PubMed, Science direct, Cochrane library, and Research gate. The efficacy of adjuvant therapy was assessed by Derkay score, surgery interval, and number of surgeries. The study steps were displayed in PRISMA 2020 flow and data analysis used RevMan 5.4.
Result: Sixteen cohort articles met the eligibility criteria. HPV vaccine adjuvant therapy significantly reduced Derkay score (SMD -1.15; CI 95% -2.27 until -0.03; p=0.004; I2=75%), extend the operation interval (SMD 0.77; CI 95% 0.20 until 1.3; p=0.008; I2=63%), and lower the number of operations (SMD -1.67; CI 95% -2.31 until -1.04; p<0.00001; I2=57%). Intralesional cidofovir adjuvant therapy did not significantly prolong the operative interval (SMD 0.25; CI 95% -0.21 until 0.72; p=0.28; I2=49%) and lower the number of operations (SMD -0.21; CI 95% -1.40 until 0.97; p=0.72; I2=84%), significantly lowered the Derkay score (SMD -1.24; CI 95% -2.24 until -0.24; p=0.02; I2=73%)..
Conclusion: HPV vaccine efficacy was shown to be equally effective in reducing Derkay scores compared to intralesional cidofovir in patients with RRP. HPV vaccine efficacy was shown to better prolong the interval and decrease the number of surgeries compared to intralesional cidofovir in patients with RRP.
