title: Doxycycline Sclerotherapy Is Superior in the Treatment of Pediatric Lymphatic Malformations.
abstract: OBJECTIVE
  To evaluate efficacy of sclerotherapy with doxycycline versus sodium tetradecyl sulfate (STS) for treatment of macrocystic and mixed lymphatic malformations (LMs).
  
  
  METHODS
  This 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.
  
  
  RESULTS
  With 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).
  
  
  CONCLUSIONS
  Doxycycline 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.
authors: Departments of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California. Electronic address: Danselmo@chla.usc.edu.
authors: Debi M
authors: DM
authors: Thomas
authors: Departments of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California.
authors: Minna M
authors: MM
authors: Wieck
authors: Departments of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California.
authors: Christa N
authors: CN
authors: Grant
authors: Departments of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California.
authors: Avafia
authors: A
authors: Dossa
authors: Departments of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California.
authors: Donna
authors: D
authors: Nowicki
authors: Radiology, Children's Hospital Los Angeles, Los Angeles, California.
authors: Phillip
authors: P
authors: Stanley
authors: Radiology, Children's Hospital Los Angeles, Los Angeles, California.
authors: Chadi
authors: C
authors: Zeinati
authors: Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California.
authors: Lori K
authors: LK
authors: Howell
authors: Departments of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California.
authors: Dean M
authors: DM
authors: Anselmo
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004318:Doxycycline / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007223:Infant; D015141:Los Angeles; D044148:Lymphatic Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D008220:Lymphography; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D012981:Sodium Tetradecyl Sulfate / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D012597:Sclerosing Solutions; D004318:Doxycycline; D012981:Sodium Tetradecyl Sulfate