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. 2015 Sep;10(3):1013-1018.
doi: 10.3892/etm.2015.2609. Epub 2015 Jul 1.

Efficacy of low-dose 90Sr-90Y therapy combined with topical application of 0.5% timolol maleate solution for the treatment of superficial infantile hemangiomas

Hong-Jian Zhu  1 , Qinghong Liu  2 , Xiao-Li Deng  3 , Yan-Xing Guan  1
Affiliations

Efficacy of low-dose 90Sr-90Y therapy combined with topical application of 0.5% timolol maleate solution for the treatment of superficial infantile hemangiomas

Hong-Jian Zhu et al. Exp Ther Med. 2015 Sep.

Abstract

The aim of the present study was to investigate the clinical efficacy and safety of low-dose 90Sr-90Y therapy combined with the topical application of 0.5% timolol maleate solution for the treatment of superficial infantile hemangiomas (IHs). A total of 72 infants with hemangiomas were allocated at random into the observation group (17 cases aged ≤3 months, 20 cases aged >3 months) or the control group (15 cases aged ≤3 months, 20 cases aged >3 months). The observation group was treated with low-dose 90Sr-90Y combined with timolol, while the control group received an identical dose of 90Sr-90Y with physiological saline. Data were collected for statistical analysis, and treatment efficacy was compared between the two groups. In the observation group, 100% (37/37) of subjects exhibited an 'excellent' response to the treatment, while 94.1% (16/17) of patients aged ≤3 months and 85.0% (17/20) aged >3 months were classed as being cured. In the control group, the treatment was classed as 'effective' in 100% (35/35) of the subjects, while the excellent response rate was 86.7% (13/15) among the infants aged ≤3 months and 75.0% (15/20) among the infants aged >3 months. The 'cure' rates in the control group were 66.7% (10/15) and 60.0% (12/20) for the ≤3-month- and >3-month-old subjects, respectively. The excellent response and cure rates were notably higher in the observation group than those in the control group. Comparison between the two groups revealed a χ2 value of 13.90 (P<0.01) for excellent responses in subjects aged ≤3 months, while for patients aged >3 months the χ2 value was 28.57 (P<0.01). Analysis of the cure responses gave similar results [≤3 months, χ2=23.22 (P<0.01); >3 months, χ2=15.67 (P<0.01)]. At 3-4 months after the first course of treatment, the cure rate was 33.3% (11/33) in the observation group, which was significantly higher than the rate of 18.32% (4/22) in the control group (χ2=5.92, P<0.05). No serious adverse reactions were observed in either group. In summary, low-dose 90Sr-90Y therapy combined with the topical application of 0.5% timolol maleate induces a rapid response in superficial IH, with excellent efficacy and no obvious adverse reactions, and may represent a clinically applicable intervention.

Keywords: 90Sr-90Y application; low dose; superficial infantile hemangioma; timolol maleate; topical.

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Figures

Figure 1.
Figure 1.
Efficacy of treatment for a left-eye superficial hemangioma: (A) Before treatment and (B) 1 month after treatment withdrawal. A total dose of 11 Gy 90Sr-90Y was applied in a single course combined with 0.5% topical timolol treatment for 6 months.
Figure 2.
Figure 2.
Efficacy of treatment for a left-forearm superficial hemangioma: (A) Before treatment and (B) 6 months after treatment withdrawal. A total dose of 11 Gy 90Sr-90Y was applied in a single course combined with 0.5% topical timolol treatment for 6 months.
Figure 3.
Figure 3.
Efficacy of treatment for a left-crus superficial hemangioma: (A) Before treatment and (B) 3 months after treatment withdrawal. A total dose of 22 Gy 90Sr-90Y was applied in 2 courses combined with 0.5% topical timolol treatment for 6 months.
Figure 4.
Figure 4.
Partial pigment formation with high-dose applicator therapy: (A) Before and (B) after treatment. The patient received 3 courses of 90Sr-90Y treatment from January 2008, with a total radiation dose of 50 Gy. Mild pigmentation remained visible on the treatment site at the 3-year follow-up.
See this image and copyright information in PMC

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