Radiation therapy for life- or function-threatening infant hemangioma.
OBJECTIVE
To assess the effectiveness and long-term results of radiation therapy in infants with life- or function-threatening hemangiomas.


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.


CONCLUSIONS
Radiation therapy (in doses of < or = 10 Gy in 2-Gy fractions) is indicated for life-threatening hemangiomas and for some function-threatening hemangiomas.
Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Japan. oginoro@med.yokohama-cu.ac.jp
I
I
Ogino
K
K
Torikai
S
S
Kobayasi
N
N
Aida
M
M
Hata
H
H
Kigasawa
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D016896:Treatment Outcome