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Role of intralesional bleomycin and intralesional triamcinolone therapy in residual haemangioma following propranolol.
Int J Oral Maxillofac Surg 2018; 47(7):908-912IJ

Abstract

With the emergence of propranolol as the first choice of treatment for problematic infantile haemangioma at many centres, the number of patients with a partial or non-response to propranolol has also been growing. This study investigated the role of intralesional bleomycin and triamcinolone in patients with residual disease following propranolol therapy for infantile haemangioma. Sixty-seven patients with residual haemangioma were assigned randomly to receive either intralesional bleomycin (group A, n=36) or intralesional triamcinolone (group B, n=31). The response to treatment and adverse effects were assessed in both groups. All patients received at least four doses and a maximum of six doses of the assigned drug. In group A (mean follow-up 9.38months), 47.2% had an excellent response and 44.4% a good response. In group B (mean follow-up 7.42months), 25.8% had an excellent response and 48.4% a good response. There was no difference in overall response between the groups (P=0.074). Among patients who were initially non-responders to propranolol, bleomycin showed a better response than triamcinolone (P=0.037). This may be due to an overlap in the mechanism of action of propranolol and triamcinolone. Thus, intralesional bleomycin should be preferred in patients with no initial response to propranolol therapy, while bleomycin or triamcinolone can be used in patients with a partial response to propranolol therapy, as they have equal efficacy.

Authors+Show Affiliations

Department of Paediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India.Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India. Electronic address: drtiwaripreeti@gmail.com.Department of Paediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India.Department of Paediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India.Department of Medicine, Institute of Medical Sciences, Banaras Hindu University Varanasi, UP, India.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

29665992

Citation

Pandey, V, et al. "Role of Intralesional Bleomycin and Intralesional Triamcinolone Therapy in Residual Haemangioma Following Propranolol." International Journal of Oral and Maxillofacial Surgery, vol. 47, no. 7, 2018, pp. 908-912.
Pandey V, Tiwari P, Sharma SP, et al. Role of intralesional bleomycin and intralesional triamcinolone therapy in residual haemangioma following propranolol. Int J Oral Maxillofac Surg. 2018;47(7):908-912.
Pandey, V., Tiwari, P., Sharma, S. P., Kumar, R., & Singh, O. P. (2018). Role of intralesional bleomycin and intralesional triamcinolone therapy in residual haemangioma following propranolol. International Journal of Oral and Maxillofacial Surgery, 47(7), pp. 908-912. doi:10.1016/j.ijom.2018.03.024.
Pandey V, et al. Role of Intralesional Bleomycin and Intralesional Triamcinolone Therapy in Residual Haemangioma Following Propranolol. Int J Oral Maxillofac Surg. 2018;47(7):908-912. PubMed PMID: 29665992.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of intralesional bleomycin and intralesional triamcinolone therapy in residual haemangioma following propranolol. AU - Pandey,V, AU - Tiwari,P, AU - Sharma,S P, AU - Kumar,R, AU - Singh,O P, Y1 - 2018/04/14/ PY - 2017/10/23/received PY - 2018/01/17/revised PY - 2018/03/22/accepted PY - 2018/4/19/pubmed PY - 2018/12/12/medline PY - 2018/4/19/entrez KW - bleomycin KW - haemangioma KW - intralesional therapy KW - triamcinolone SP - 908 EP - 912 JF - International journal of oral and maxillofacial surgery JO - Int J Oral Maxillofac Surg VL - 47 IS - 7 N2 - With the emergence of propranolol as the first choice of treatment for problematic infantile haemangioma at many centres, the number of patients with a partial or non-response to propranolol has also been growing. This study investigated the role of intralesional bleomycin and triamcinolone in patients with residual disease following propranolol therapy for infantile haemangioma. Sixty-seven patients with residual haemangioma were assigned randomly to receive either intralesional bleomycin (group A, n=36) or intralesional triamcinolone (group B, n=31). The response to treatment and adverse effects were assessed in both groups. All patients received at least four doses and a maximum of six doses of the assigned drug. In group A (mean follow-up 9.38months), 47.2% had an excellent response and 44.4% a good response. In group B (mean follow-up 7.42months), 25.8% had an excellent response and 48.4% a good response. There was no difference in overall response between the groups (P=0.074). Among patients who were initially non-responders to propranolol, bleomycin showed a better response than triamcinolone (P=0.037). This may be due to an overlap in the mechanism of action of propranolol and triamcinolone. Thus, intralesional bleomycin should be preferred in patients with no initial response to propranolol therapy, while bleomycin or triamcinolone can be used in patients with a partial response to propranolol therapy, as they have equal efficacy. SN - 1399-0020 UR - https://www.unboundmedicine.com/medline/citation/29665992/Role_of_intralesional_bleomycin_and_intralesional_triamcinolone_therapy_in_residual_haemangioma_following_propranolol_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0901-5027(18)30111-5 DB - PRIME DP - Unbound Medicine ER -