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(Radiology. 2001;218:834-839.)
© RSNA, 2001

Radiation Oncology

Radiation Therapy for Life- or Function-threatening Infant Hemangioma1

Ichiro Ogino, MD, Katsuyuki Torikai, MD, Shinji Kobayasi, MD, Noriko Aida, MD, Masaharu Hata, MD and Hisato Kigasawa, MD

1 From the Departments of Radiology (I.O., N.A., M.H.), Plastic and Reconstructive Surgery (K.T., S.K.), and Hematology (H.K.), Kanagawa Children’s Medical Center, Yokohama, Japan. Received January 17, 2000; revision requested March 5; final revision received July 10; accepted August 2. I.O. supported by a grant from the Children’s Cancer Association of Japan. Address correspondence to I.O., Department of Radiology, Yokohama City University, School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan (e-mail: oginoro@med.yokohama-cu.ac.jp).

PURPOSE: To assess the effectiveness and long-term results of radiation therapy in infants with life- or function-threatening hemangiomas.

MATERIALS AND METHODS: Thirteen patients with life- or function-threatening hemangiomas (eight male, five female; age range, 0–8 months; median age, 2 months) were treated with radiation therapy. Life-threatening hemangiomas were treated with five fractions of radiation per week, and function-threatening hemangiomas were treated with two fractions per week. A median dose of 10 Gy was delivered to each hemangioma. The presence of residual hemangiomas, skin changes, functional problems, and growth delay was evaluated.

RESULTS: All patients with Kasabach-Merritt syndrome (KMS) showed regression of the hemangioma and an increase in platelet counts to greater than 100,000 per cubic millimeter (1.0 x 1011 per liter) within 40 days after radiation therapy. The treatment field was inadequate in two patients who required reirradiation or a change of treatment portal. With the exception of the patients with KMS, all but one patient experienced relief from symptoms in 40 days. Severe long-term radiation-related morbidity was noted in one patient who required reirradiation for a relapsed hemangioma.

CONCLUSION: Radiation therapy (in doses of <=10 Gy in 2-Gy fractions) is indicated for life-threatening hemangiomas and for some function-threatening hemangiomas.

Index terms: Angioma, soft tissues, 9*.312 • Therapeutic radiology, in infants and children




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