Pharmacological therapies for infantile hemangiomas: A clinical study in 853 consecutive patients using a standard treatment algorithm.
Pharmacological therapies for infantile hemangiomas: A clinical study in 853 consecutive patients using a standard treatment algorithm.
复制标题
婴儿血管瘤的药物治疗：使用标准治疗算法对 853 名连续患者进行的临床研究
DOI：
10.1038/srep21670
复制
发表时间：
2016-02-15
影响因子：
4.6
通讯作者：
Zheng JW
中科院分区：
文献类型：
--
作者：
Zhang L;Yuan WE;Zheng JW
婴儿血管瘤是最常见的婴儿良性血管肿瘤。虽然大多数婴儿血管瘤增生，然后渐开式，一些可能会持续存在，需要治疗的原因包括毁容或功能损害的风险。目前的治疗方法包括观察、药物治疗、激光、冷冻手术、手术和放疗。虽然药物治疗是一种被广泛接受的治疗选择，但有限的研究评估了不同药物治疗的疗效。在这项研究中，我们比较不同的药物治疗方式在婴儿血管瘤的管理。该研究包括853名患有增生性婴儿血管瘤的婴儿，他们在2009年至2012年期间接受了局部替马洛尔、口服心得安、局部平阳霉素或静脉注射长春新碱治疗。治疗分层是基于肿瘤的临床严重程度。对治疗的反应进行临床评估并分为：极好、良好、差或无反应。几乎所有婴儿血管瘤对药物治疗的反应都很好。此外，年龄小于8个月的患者对药物治疗的反应较高（89.1%），而年龄大于8个月的患者对药物治疗的反应较低（36.3%）。没有发生危及生命的并发症。总的来说，这些发现支持噻莫洛尔、心得安、平阳霉素和长春新碱治疗婴儿血管瘤的疗效，特别是在最年轻的患者队列中（8个月或更小）。
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).