Bleomycin for Head and Neck Venolymphatic Malformations: A Systematic Review

Area of Science:

• Vascular Surgery
• Dermatology
• Pediatric Surgery

Background:

• Venolymphatic malformations are rare, benign vascular lesions predominantly affecting the head and neck.
• Sclerotherapy is the established first-line treatment for these conditions.
• Bleomycin is a frequently utilized sclerosing agent in this therapeutic context.

Purpose of the Study:

• To systematically review existing literature on the safety and efficacy of bleomycin for treating head and neck venolymphatic malformations.
• To synthesize current evidence regarding bleomycin's effectiveness and potential complications.

Main Methods:

• A systematic literature review was conducted across PubMed, Embase, and Cochrane Library databases.
• Studies published between January 1995 and May 2019 focusing on sclerotherapy for head and neck venolymphatic malformations were included.
• Data from 32 studies, encompassing 1121 patients, were analyzed for lesion size reduction and complication rates.

Main Results:

• Bleomycin/pingyangmycin sclerotherapy resulted in subjective or objective lesion size reduction in 96.3% of patients.
• Minor complications were reported in 16.2% of cases.
• Major complications occurred in a low rate of 1.1% of patients.

Conclusions:

• Bleomycin demonstrates high efficacy in treating head and neck venolymphatic malformations.
• The treatment is associated with a low incidence of major adverse events.
• The available evidence is derived from low-to-moderate quality studies, highlighting a need for further research.