Document Detail


Oral proliferative verrucous leukoplakia (PVL); open trial of surgery compared with combined therapy using surgery and methisoprinol in papillomavirus-related PVL.
MedLine Citation:
PMID:  11518355     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Proliferative verrucous leukoplakia (PVL) is a unique oral white lesion in which human papillomavirus (HPV) may play a role. PVL behaves far more aggressively than other forms of leukoplakia with a high rate of recurrence after surgical excision, and relentless progression to verrucous hyperplasia and to verrucous or squamous cell carcinomas. The treatment of PVL is usually by surgery, but there is often early recurrence. This study was an open trial of surgery in 25 patients with oral HPV-positive PVL, compared with combined therapy using surgery and methisoprinol in another group of 25 patients with oral PVL. Six months postoperatively there was a significant difference, with 18 recurrences in the patients treated by surgery alone compared to only two recurrences in the patients treated also with methisoprinol (isoprinosine or inosine pranobex), a synthetic agent with immunomodulatory properties and some antiviral activity against HPV. Eighteen months postoperatively there were no further recurrences in the patients treated by surgery alone but another two recurrences in the patients treated with methisoprinol. Overall, by 18 months follow-up, there were 18 recurrences in the group treated by surgery alone, compared with four in those also receiving methisoprinol. The use of this antiviral agent appeared to offer a significant enhancement to the surgical management of PVL.
Authors:
F Femiano; F Gombos; C Scully
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  International journal of oral and maxillofacial surgery     Volume:  30     ISSN:  0901-5027     ISO Abbreviation:  Int J Oral Maxillofac Surg     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-23     Completed Date:  2001-10-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8605826     Medline TA:  Int J Oral Maxillofac Surg     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  318-22     Citation Subset:  D; IM    
Affiliation:
Stomatology Clinic, II University of Medicine and Surgery, Napoli, Italy. femiano@libero.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antiviral Agents / therapeutic use*
Chi-Square Distribution
Combined Modality Therapy
DNA Probes, HPV
Female
Humans
Inosine Pranobex / therapeutic use*
Leukoplakia, Oral / drug therapy*,  pathology,  surgery*,  virology
Male
Middle Aged
Mouth Neoplasms / drug therapy*,  pathology,  surgery*,  virology
Neoplasm Recurrence, Local
Papillomaviridae / isolation & purification
Treatment Outcome
Warts / drug therapy,  surgery
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/DNA Probes, HPV; 36703-88-5/Inosine Pranobex

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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