Zhang Yu-Tong, Zhang Chao, Wang Yu, Chang Jian
Department of Pediatric Oncology, The First Hospital of Jilin University, Changchun, China.
Front Pediatr. 2022 Jul 19;10:935470. doi: 10.3389/fped.2022.935470. eCollection 2022.
This work aimed to report our experience with ultrasound-guided instillation for the treatment of lymphangiomas in children, so as to determine whether the combined use of bleomycin and dexamethasone achieved a higher response rate and a lower side effect rate.
The medical records from patients with lymphangiomas between January 1st, 2013 and September 31st, 2020, were reviewed. Patients who received bleomycin combined with dexamethasone sclerotherapy were classified as the dexamethasone group, while those receiving bleomycin without dexamethasone were classified as the control group.
Altogether one hundred and twenty-seven patients were diagnosed with lymphangiomas. Among them, one hundred and five patients received bleomycin combined with dexamethasone injection, while the remaining twenty-two received bleomycin injection alone. The excellent rates were 89.52% [95% confidence interval (CI), 81.64-94.40%] in the dexamethasone group and 72.73% (95% CI, 52.51-92.94%) in the control group ( < 0.05). Additionally, the recurrence rates were 3.81% (95% CI, 1.22-10.03%) in the dexamethasone group and 13.64% (95% CI, 3.6-36.0%) in the control group ( > 0.05). After comparison between the two groups, the following risk factors were identified. These include >10 sacs at the initial stage of diagnosis, larger size after all injections, and response to the first injection.
Although there was no significant difference in the recurrence rate between the two groups, this retrospective study demonstrated that the excellent response rates were dramatically improved between the two groups, suggesting that bleomycin combined with DEX was an effective and highly safe treatment for all types of pediatric lymphangiomas. Moreover, this study also identified three novel features as the significant risk factors for recurrence.
本研究旨在报告我们使用超声引导注射治疗儿童淋巴管瘤的经验，以确定博来霉素与地塞米松联合使用是否能获得更高的缓解率和更低的副作用发生率。
回顾了2013年1月1日至2020年9月31日期间淋巴管瘤患者的病历。接受博来霉素联合地塞米松硬化治疗的患者被归为地塞米松组，而接受单纯博来霉素治疗的患者被归为对照组。
共诊断出127例淋巴管瘤患者。其中，105例患者接受了博来霉素联合地塞米松注射，其余22例仅接受了博来霉素注射。地塞米松组的优良率为89.52%[95%置信区间（CI），81.64 - 94.40%]，对照组为72.73%（95%CI，52.51 - 92.94%）（P<0.05）。此外，地塞米松组的复发率为3.81%（95%CI，1.22 - 10.03%），对照组为13.64%（95%CI，3.6 - 36.0%）（P>0.05）。两组比较后，确定了以下危险因素。这些因素包括诊断初期囊肿>10个、所有注射后囊肿较大以及对首次注射的反应。
虽然两组的复发率无显著差异，但这项回顾性研究表明两组之间的优良缓解率有显著提高，提示博来霉素联合地塞米松是治疗所有类型儿童淋巴管瘤的一种有效且高度安全的方法。此外，本研究还确定了三个新的特征作为复发的重要危险因素。
