Doxycycline Sclerotherapy Is Superior in the Treatment of Pediatric Lymphatic Malformations

Debi M. Thomas, Minna M. Wieck, Christa Grant, Avafia Dossa, Donna Nowicki, Phillip Stanley, Chadi Zeinati, Lori K. Howell, Dean M. Anselmo

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose To evaluate efficacy of sclerotherapy with doxycycline versus sodium tetradecyl sulfate (STS) for treatment of macrocystic and mixed lymphatic malformations (LMs). Materials and 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.

Original languageEnglish (US)
Pages (from-to)1846-1856
Number of pages11
JournalJournal of Vascular and Interventional Radiology
Volume27
Issue number12
DOIs
StatePublished - Dec 1 2016

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Sclerotherapy
Doxycycline
Sodium Tetradecyl Sulfate
Pediatrics
Therapeutics

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Thomas, Debi M. ; Wieck, Minna M. ; Grant, Christa ; Dossa, Avafia ; Nowicki, Donna ; Stanley, Phillip ; Zeinati, Chadi ; Howell, Lori K. ; Anselmo, Dean M. / Doxycycline Sclerotherapy Is Superior in the Treatment of Pediatric Lymphatic Malformations. In: Journal of Vascular and Interventional Radiology. 2016 ; Vol. 27, No. 12. pp. 1846-1856.
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abstract = "Purpose To evaluate efficacy of sclerotherapy with doxycycline versus sodium tetradecyl sulfate (STS) for treatment of macrocystic and mixed lymphatic malformations (LMs). Materials and 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.",
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Thomas, DM, Wieck, MM, Grant, C, Dossa, A, Nowicki, D, Stanley, P, Zeinati, C, Howell, LK & Anselmo, DM 2016, 'Doxycycline Sclerotherapy Is Superior in the Treatment of Pediatric Lymphatic Malformations', Journal of Vascular and Interventional Radiology, vol. 27, no. 12, pp. 1846-1856. https://doi.org/10.1016/j.jvir.2016.08.012

Doxycycline Sclerotherapy Is Superior in the Treatment of Pediatric Lymphatic Malformations. / Thomas, Debi M.; Wieck, Minna M.; Grant, Christa; Dossa, Avafia; Nowicki, Donna; Stanley, Phillip; Zeinati, Chadi; Howell, Lori K.; Anselmo, Dean M.

In: Journal of Vascular and Interventional Radiology, Vol. 27, No. 12, 01.12.2016, p. 1846-1856.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Doxycycline Sclerotherapy Is Superior in the Treatment of Pediatric Lymphatic Malformations

AU - Thomas, Debi M.

AU - Wieck, Minna M.

AU - Grant, Christa

AU - Dossa, Avafia

AU - Nowicki, Donna

AU - Stanley, Phillip

AU - Zeinati, Chadi

AU - Howell, Lori K.

AU - Anselmo, Dean M.

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Purpose To evaluate efficacy of sclerotherapy with doxycycline versus sodium tetradecyl sulfate (STS) for treatment of macrocystic and mixed lymphatic malformations (LMs). Materials and 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.

AB - Purpose To evaluate efficacy of sclerotherapy with doxycycline versus sodium tetradecyl sulfate (STS) for treatment of macrocystic and mixed lymphatic malformations (LMs). Materials and 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.

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