Abstract
Infantile hemangiomas are the most common infantile benign vascular tumor. While most infantile hemangiomas proliferate then involute, some may persist and require treatment for reasons including risk of disfigurement or functional impairment. Treatments currently include observation, pharmacological therapy, laser, cryosurgery, surgery and radiotherapy. Although pharmacological therapy is a well accepted treatment option, limited studies have evaluated the efficacy of different drug therapies. In this study, we compare different pharmacological modalities in the management of infantile hemangiomas. The study included 853 infants with proliferative infantile hemangiomas who were treated with topical timolol, oral propranolol, intralesional pingyangmycin, or intravenous vincristine from 2009 to 2012. Treatment stratification was based on clinical severity of the tumor. Response to the treatment was clinically evaluated and graded as: excellent, good, poor, or no response. Response to pharmacological therapies was excellent in almost all infantile hemangiomas. In addition, patients younger than 8 months responded highly to pharmacological treatment (89.1%), while patients older than 8 months were less responsive to treatment (36.3%). There were no instances of life-threatening complications. Overall, these findings support the efficacy of timolol, propranolol, pingyangmycin and vincristine in the treatment of infantile hemangiomas, especially in the youngest patient cohort (8 months or younger).
Highlights
Life threatening infantile hemangiomas[7]
We reveal the results of treating patients with infantile hemangiomas with timolol, propranolol, pingyangmycin and vincristine, and in turn, propose a comprehensive treatment algorithm for infantile hemangiomas
There is no single drug that can be effective and universal treatment for all hemangiomas[20]. This is largely due to the diverse presentation of infantile hemangiomas in patients
Summary
This clinical research was approved by the Ninth People’s Hospital, Shanghai Jiao Tong. The human subject protocol was approved by the Committee on Clinical Investigation. Clinical diagnoses of infantile hemangioma were confirmed by the Department of Oral-maxillary, head and neck surgery at Ninth People’s Hospital Shanghai. Informed consent was obtained in accordance with The World Medical Association Declaration of Helsinki. All the following methods were carried out in accordance with the approved guidelines (http://jama.jamanetwork.com/article.aspx?articleid= 1760318)
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