title: Beta-blockers for childhood vascular tumors.
abstract: OBJECTIVE
  Since 2008, beta-blockers have become first-line treatment for infantile hemangiomas, the most common tumor of infancy. Their role is also being explored in the treatment of other childhood vascular tumors.
  
  
  RESULTS
  Recent research has demonstrated that propranolol is a more effective and safer treatment for infantile hemangiomas than previous therapeutic options. It is most effective when initiated during the tumor's proliferative phase. Other oral beta-blockers such as atenolol and nadolol are less studied, but may offer similar efficacy. Topical beta-blockers such as timolol appear to be effective in treating small, superficial infantile hemangiomas. Beta-blockers have shown variable results for the treatment of other vascular tumors of childhood, such as pyogenic granulomas, kaposiform hemangioendotheliomas, and tufted angiomas.
  
  
  CONCLUSIONS
  Propranolol has revolutionized the treatment of infantile hemangiomas, and other beta-blockers provide promising alternatives. Unanswered questions remain about the optimal choice of agent, delivery mechanism, dosage, need for pretreatment evaluation or ongoing monitoring, and duration of therapy. The role of beta-blockers in treating other types of vascular tumors requires further study.
authors.affiliation: aDepartment of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio bDivision of Dermatology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA.
authors.forename: Cheryl B
authors.initials: CB
authors.lastname: Bayart
authors.forename: Heather A
authors.initials: HA
authors.lastname: Brandling-Bennett
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D001262:Atenolol / Q000008:administration & dosage; D002675:Child, Preschool; D005153:Facial Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D009386:Neoplastic Syndromes, Hereditary; D020752:Neurocutaneous Syndromes / Q000188:drug therapy* / Q000473:pathology; D011433:Propranolol / Q000008:administration & dosage*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013999:Timolol / Q000008:administration & dosage; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000319:Adrenergic beta-Antagonists; D001262:Atenolol; D013999:Timolol; D011433:Propranolol