Vincristine treatment for function- and life-threatening infantile hemangioma
Vincristine treatment for function- and life-threatening infantile hemangioma
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DOI：
10.1016/j.arcped.2003.10.014
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发表时间：
2004-02-01
影响因子：
1.8
通讯作者：
Leverger, G
中科院分区：
文献类型：
--
作者：
Enjoras, O;Brevière, GM;Leverger, G
瞄准- 评价长春新碱治疗危及功能和生命的血管瘤的疗效。患者和方法。- 9名婴儿，8名女孩和1名男孩，接受长春新碱治疗（VCR）危及血管瘤。在6例病例中，血管瘤累及头部和颈部，呈节段性单侧或双侧分布（3/6例还累及喉和2/6例气管，导致呼吸窘迫，5/6例累及眼睑和眼眶）; 1例婴儿患有播散性新生儿血管瘤病（皮肤、肝脏）。肾）：两名婴儿患有肝血管瘤伴心力衰竭。6例患儿在高剂量皮质类固醇治疗失败后，1例患儿在皮质类固醇和干扰素α 2b联合治疗（5个月）失败后，给予VCR治疗; 2例患儿接受VCR作为一线治疗。- 静脉注射1 mg/m2的剂量，首先每周注射一次，然后逐渐减少，根据临床反应增加注射间隔。9名婴儿接受了5至25次注射（平均16次），治疗时间为1.5-8个月（平均5.5个月）。在7名患者中，在治疗的第一个月结束时观察到明显的临床反应，而在2名患者中观察到缓慢的持续反应。4例患者出现一过性轻度副作用。- 皮质类固醇治疗虽然是世界公认的有问题的血管瘤的治疗方法，但不能总是控制令人担忧的血管瘤的生长。干扰素α 2a和2b已被证明有90%的有效性：治疗皮质抵抗性、功能和生命威胁性血管瘤。(C)2003年，Elsevier SAS。
Aim. - To evaluate the efficacy of vincristine treatment for function- and life-threatening hemangiomas.Patients and method. - Nine infants, eight girls and one boy, received vincristine treatment (VCR) for endangering hemangiomas. In six cases, the hemangiomas involved head and neck in a segmental unilateral or bilateral distribution (3/6 also had laryngeal and 2/6 tracheal location causing respiratory distress, 5/6 had eyelid and orbital involvement); one infant had disseminated neonatal hemangiomatosis (skin, liver. kidney): two infants had liver hemangiomas with cardiac failure. VCR was prescribed after failure of high-dosage corticosteroid treatment in six, and of both corticosteroids and interferon alpha 2b (5 months) in one; two infants received VCR as first line treatment.Results. - A dosage of 1 mg/m(2) IV injection was delivered, with weekly injections first, and then tapering, increasing the interval between injections, depending on the clinical response. The nine infants received from 5 to 25 injections (average: 16), for a length of treatment of 1.5-8 months (average: 5.5 months). In seven patients a clear clinical response was observed at the end of the first month of treatment, while a slow protracted response was noted in two. Transient mild side effects were present in four patients.Discussion. - Corticosteroid treatment, although a worldwide recognized treatment of problematic hemangiomas, cannot always control the growth of alarming hemangiomas. Interferon alpha 2a and 2b have proven a 90% effectiveness: treatment for cortico-resistant, function- and life-threatening, hemangiomas. (C) 2003 Elsevier SAS.