The Efficacy of Human Papillomavirus Vaccination as an Adjuvant Therapy in Recurrent Respiratory Papillomatosis

Abstract

ObjectiveTo characterize the efficacy of human papillomavirus (HPV) vaccination as an adjuvant therapy in recurrent respiratory papillomatosis (RRP).Data SourcesPubMed, Embase, Cochrane, Google Scholar, ClinicalTrials.gov, and Web of Science databases were queried for articles published before April 2021.Review MethodsAll retrieved studies (n = 870) were independently analyzed by two reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) statement using predefined inclusion and exclusion criteria. 13 studies met inclusion criteria. A random‐effects meta‐analysis was performed to study intersurgical interval (ISI) and number of surgical procedures per year before and after vaccination.ResultsThe systematic review included 13 studies, comprising 243 patients. All studies utilized the Gardasil® quadrivalent vaccine, and one study (Yiu et al. 2019) utilized both the quadrivalent and Gardasil® 9‐valent vaccines. Our meta‐analysis included 62 patients with ISI data across 4 studies, and 111 patients with data on the number of surgical procedures per month across 7 studies. The mean number of surgical procedures decreased by 4.43 per year after vaccination (95% CI, −7.48 to −1.37). Mean ISI increased after vaccination, with a mean difference of 15.73 months (95% CI, 1.46–29.99). Two studies reported on HPV sero‐conversion, with HPV seropositivity of 100% prior to vaccination and 25.93% after vaccination.ConclusionThe addition of HPV vaccination was associated with an increase in time between surgeries and reduction in the number of surgical procedures required. HPV vaccination may be a beneficial adjuvant treatment for RRP.Level of EvidenceNA Laryngoscope, 133:2046–2054, 2023