How would you manage recurrent laryngeal papillomatosis requiring multiple resections of lesions with pathology never revealing any degree of dysplasia?

Would you offer definitive radiation, and if so, to what volume and dose/fractionation? Would your recommendation differ depending on if repeat resections are feasible (without resorting to tracheostomy or laryngectomy.

Answer from: Radiation Oncologist at Academic Institution

I am not aware of any study of radiotherapy for laryngeal papillomatosis. It is not included in the usual indications for radiotherapy of benign disease. Thus, no radiotherapy. An alternative to repeated surgeries may be photodynamic laser (Motz and Hillel, PMID 27242951).

Answer from: Radiation Oncologist at Community Practice

There are limited data but some exist.If no other options and the patient understands the risks, it may be worth exploring.Byhardt and Almagro, PMID 3282424GALLOWAY et al., PMID 13826182

Comments

Radiation Oncologist at Iowa City Cancer Treatment Center
No literature support that I am aware of.

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How would you manage recurrent laryngeal papillomatosis requiring multiple resections of lesions with pathology never revealing any degree of dysplasia?

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