Doxycycline Sclerotherapy Is Superior in the Treatment of Pediatric Lymphatic Malformations

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• 作者：Debi M. Thomas ; MD^a ; ^{Danselmo@chla.usc.edu} ; Minna M. Wieck ; MD^a ; Christa N. Grant ; MD^a ; Avafia Dossa ; MD^a ; Donna Nowicki ; RN ; CPNP-PC^a ; Phillip Stanley ; MD^b ; Chadi Zeinati ; MD^b ; Lori K. Howell ; MD^c ; Dean M. Anselmo ; MD^a
• 关键词：LM ; lymphatic malformations ; STS ; sodium tetradecyl sulfate
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：27
• 期：12
• 页码：1846-1856
• 全文大小：4697 K
• 卷排序：27

文摘

To evaluate efficacy of sclerotherapy with doxycycline versus sodium tetradecyl sulfate (STS) for treatment of macrocystic and mixed lymphatic malformations (LMs).Materials and MethodsThis single-center retrospective review identified 41 children (17 boys; 24 girls; age range, 1 month to 15.4 y) who underwent sclerotherapy with doxycycline (n = 32) or STS (n = 9) for macrocystic (n = 31) or mixed (n = 10) LMs. There were 114 treatments performed, averaging 2.8 treatments (range, 1–8 treatments) per patient. Average follow-up time was 10 months (range, 1–59 months). Clinical response was deemed excellent or moderate if > 90% or > 50% of LMs resolved based on visual estimate.ResultsWith doxycycline, 87% of patients (28 of 32) had excellent or moderate response with an average of 2.8 treatments (range, 1–7 treatments); 13% required subsequent resection. With 3% STS monotherapy, only 55% of patients (5 of 9) had excellent or moderate response with an average of 2.8 treatments (range, 1–8 treatments), and 33% required subsequent resection. Significantly fewer patients treated with STS responded well compared with patients treated with doxycycline (P = .03). Patients treated with STS had significantly longer follow-up than patients treated with doxycycline (27 months vs 6 months, P = .0001).ConclusionsDoxycycline monotherapy resulted in a high rate of excellent clinical outcomes after a few treatments without increased need for subsequent operative resection. These results support use of doxycycline sclerotherapy as primary treatment for macrocystic and mixed LMs in children.