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Radiation therapy for life- or function-threatening infant hemangioma
I Ogino1, K Torikai, S Kobayasi
1Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Japan. oginoro@med.yokohama-cu.ac.jp
Insights
Radiation therapy effectively treats infants with dangerous hemangiomas, including those with Kasabach-Merritt syndrome. This treatment offers symptom relief and hemangioma regression with manageable long-term outcomes.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Vascular Malformations
Background:
- Hemangiomas are common benign tumors in infants.
- Life- or function-threatening hemangiomas require prompt and effective treatment.
- Radiation therapy is a potential treatment modality for complex infant hemangiomas.
Purpose of the Study:
- To evaluate the efficacy and long-term results of radiation therapy for infants with life- or function-threatening hemangiomas.
- To assess treatment outcomes in patients with Kasabach-Merritt syndrome.
- To determine the safety and potential morbidities associated with radiation therapy in this population.
Main Methods:
- A cohort of 13 infants (0-8 months) with hemangiomas received radiation therapy.
- Treatment protocols varied based on hemangioma severity (life- vs. function-threatening).
- Median radiation dose was 10 Gy, with evaluation for residual disease, skin changes, and functional deficits.
Main Results:
- All patients with Kasabach-Merritt syndrome experienced hemangioma regression and normalized platelet counts within 40 days.
- Most patients (excluding KMS) achieved symptom relief within 40 days.
- One patient required reirradiation due to relapse; one experienced severe long-term radiation-related morbidity.
Conclusions:
- Radiation therapy, with doses up to 10 Gy, is a viable treatment for life-threatening hemangiomas.
- It is also indicated for select cases of function-threatening hemangiomas.
- Careful patient selection and monitoring are essential to optimize outcomes and minimize risks.
Purpose:
To assess the effectiveness and long-term results of radiation therapy in infants with life- or function-threatening hemangiomas.
Materials And Methods:
Thirteen patients with life- or function-threatening hemangiomas (eight male, five female; age range, 0-8 months; median age, 2 months) were treated with radiation therapy. Life-threatening hemangiomas were treated with five fractions of radiation per week, and function-threatening hemangiomas were treated with two fractions per week. A median dose of 10 Gy was delivered to each hemangioma. The presence of residual hemangiomas, skin changes, functional problems, and growth delay was evaluated.
Results:
All patients with Kasabach-Merritt syndrome (KMS) showed regression of the hemangioma and an increase in platelet counts to greater than 100,000 per cubic millimeter (1.0 x 10(11) per liter) within 40 days after radiation therapy. The treatment field was inadequate in two patients who required reirradiation or a change of treatment portal. With the exception of the patients with KMS, all but one patient experienced relief from symptoms in 40 days. Severe long-term radiation-related morbidity was noted in one patient who required reirradiation for a relapsed hemangioma.
Conclusion:
Radiation therapy (in doses of < or = 10 Gy in 2-Gy fractions) is indicated for life-threatening hemangiomas and for some function-threatening hemangiomas.