Otolaryngol Head Neck Surg 1998 Jun;118(6):810-815

Preliminary results of the use of indole-3-carbinol for recurrent respiratory papillomatosis.

Rosen CA, Woodson GE, Thompson JW, Hengesteg AP, Bradlow, HL

Department of Otolaryngology--Head and Neck Surgery, University of Pittsburgh Medical Center, Pennsylvania, USA.

OBJECTIVE:

We report the preliminary results of a phase I trial using indole-3-carbinol for 
the treatment of recurrent respiratory papillomatosis. Indole-3-carbinol is 
a chemical that is found in high concentrations in cruciferous 
vegetables and has been shown to alter the growth pattern of recurrent 
respiratory papillomatosis cell cultures and to be effective in an in 
vivo animal model of recurrent respiratory papillomatosis. METHODS: 
Eighteen patients were treated with oral indole-3-carbinol and had a 
minimum follow-up of 8 months and a mean follow-up of 14.6 months. All 
patients received indole-3-carbinol, and outcome measures included a 
change in papilloma growth rate and the need for surgery during 
treatment compared with before treatment. All patients had serial 
examinations with videoendoscopy to document papilloma location and 
growth rate. RESULTS: Thirty-three percent (6 of 18) of the study 
patients had a cessation of their papilloma growth and have not required 
surgery since the start of the study. Six patients have had reduced 
papilloma growth rate, and 6 (33%) patients have shown no clinical 
response to indole-3-carbinol. Indole-3-carbinol affects the ratio of 
hydroxylation of estradiol; changes in the ratios of urinary 
2-hydroxylation and 16-hydroxylation of estradiol caused by 
indole-3-carbinol correlated well with clinical response. No major 
complications or changes in the children's growth curve were noted. 
CONCLUSIONS: The preliminary results of treating recurrent respiratory 
papillomatosis with indole-3-carbinol holds promise. Longer follow-up of 
this patient group and a blinded, controlled trial are required. We 
conclude that indole-3-carbinol appears to be safe and well tolerated 
and may be an efficacious treatment for recurrent respiratory 
papillomatosis.