Radiotherapy for life‐threatening mediastinal hemangioma with Kasabach–Merritt syndrome

Kwok‐Williams, Michelle; Perez, Zuleima; Squire, Roly; Glaser, Adam; Bew, Stephanie; Taylor, R.A.

doi:10.1002/pbc.20767

Cited by 24 publications

(28 citation statements)

References 19 publications

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“…The radiosensitivity of hemangiomas has been studied since the 1940s 20. Some authors have described symptomatic responses during treatment whereas others have reported objective responses up to 1 year after RT 16, 20.…”

Section: Discussionmentioning

confidence: 99%

The impact of tumor progesterone receptor status on optimal adjuvant endocrine therapy for postmenopausal patients with early‐stage breast cancer

Punglia

Kuntz²,

Winer

et al. 2006

Cancer

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BACKGROUNDEmerging data suggest that treatment outcomes with aromatase inhibitors (AIs) and/or tamoxifen may differ for tumors that express both the estrogen receptor (ER) and the progesterone receptor (PR) (ER+/PR+) compared with those that lack PR expression (ER+/PR−). However, the optimal sequencing of AIs and tamoxifen as adjuvant therapy is not known and may differ for biologic subsets of cancers.METHODSMarkov models were used to simulate disease‐free survival (DFS) separately among postmenopausal women with ER+/PR+ cancers and women with ER+/PR− cancers. By using risk estimates reported from randomized clinical trials, treatment with 5 years of an AI alone with sequential treatment consisting of tamoxifen with crossover to an AI at 2 years was compared.RESULTSFor women with ER+/PR+ cancers, sequential therapy with tamoxifen followed by crossover to an AI at 2 years yielded modest improvements in 10‐year DFS estimates compared with planned AI monotherapy (84.3% vs. 82.2% and 68.8% vs. 64.8% for lymph node‐negative and lymph node‐positive patients, respectively). However, for women with ER+/PR− cancers, upfront treatment with an AI yielded improved outcomes with 10‐year DFS rates of 90.5% and 80.1% for the lymph node‐negative and node‐positive groups, respectively, compared with 88.2% and 76.1%, respectively, for sequential treatment with tamoxifen followed by an AI.CONCLUSIONSModeling estimates suggested that the optimal endocrine treatment strategy may differ based on the biologic features of breast cancer tumors. Patients with ER+/PR+ tumors achieved optimal 10‐year DFS estimates with tamoxifen followed by a crossover to AI therapy, whereas patients with ER+/PR− tumors fared best when they initiated treatment with AI. Cancer 2006. © 2006 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

The impact of tumor progesterone receptor status on optimal adjuvant endocrine therapy for postmenopausal patients with early‐stage breast cancer

Punglia

Kuntz²,

Winer

et al. 2006

Cancer

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“…Historically, radiation therapy has been associated with multiple long-term side effects when used in pediatric population [60,100,[113][114][115][116] its use in adults has been more liberal. In a series of 28 patients, concurrent radiation and steroids demonstrated a 75% response rate, with no radiation-induced side effects over a median follow-up of more than 6 years [117].…”

Section: Radiationmentioning

confidence: 99%

Clinical Review: Management of Adult Kasabach-Merritt Syndrome Associated with Hemangiomas

Master¹,

Kallam²,

Eo³

et al. 2017

J Blood Disord Transfus

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Kasabach-Merritt syndrome (KMS) consists of a clinical trial of capillary hemangioma, thrombocytopenia and disseminated intravascular coagulation. KMS occurs most commonly in the pediatric population, and its occurrence in adults is rare. Specific guidelines or randomized clinical trials guiding clinical management of KMS in adult patients are lacking. This manuscript provides a comprehensive review of KMS and discusses recent advances in the medical management of KMS. We also propose a systematic therapeutic approach which would serve as a guide in the management of adult patients with KMS caused by hemangiomas.

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“…KMS is characterized by giant hemangiomas and severe thrombocytopenia, which may result in life-threatening multi-organ hemorrhage. About 80% of patients present within 1 year after birth, and the reported mortality rate ranges from 10% to 37% [1]. However, the optimal therapy for neonatal KMS is currently unclear.…”

Section: Introductionmentioning

confidence: 99%

Clinical analysis of kasabach-merritt syndrome in 17 neonates

Wang

Wei

et al. 2014

BMC Pediatr

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BackgroundKasabach-Merritt syndrome (KMS) is characterized by giant hemangiomas and severe thrombocytopenia, which may result in life-threatening multi-organ hemorrhage. This study evaluated the clinical characteristics, treatments, and outcomes in neonates with KMS, in order to find out the optimal therapy.MethodsThe clinical data of 17 patients treated for KMS in the Department of Neonates, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, China from January 2007 to January 2012 were retrospectively analyzed.ResultsThe patients were 13 males and 4 females, aged 17 hours to 28 days at admission. Four patients had visceral hemangiomas and 13 had cutaneous hemangiomas. All had thrombocytopenia and coagulation disorders. Intravenous steroid therapy was initially effective in 6 patients (of which 3 relapsed) and ineffective in 11. The 11 patients with a poor response to steroids and the 3 who relapsed underwent arterial embolization therapy, which was effective in 9 patients (of which 1 relapsed), ineffective in 4, and discontinued before completion in 1. Subsequently, four patients in whom arterial embolization therapy was ineffective and one with relapse were treated with vincristine. This was effective in four patients, and the other died of disseminated intravascular coagulation. Steroid therapy was effective in 35.3% of patients, but the relapse rate was 50%. Arterial embolization was effective in 64.3% of patients and vincristine was effective in 80%.ConclusionsIn patients with neonatal KMS, steroid therapy has a low rate of effectiveness and high rate of relapse. Arterial embolization has a good rate of effectiveness. Combined steroid and embolization therapy should be considered for first-line treatment of neonatal KMS. If this approach is ineffective, vincristine may be useful.

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Radiotherapy for life‐threatening mediastinal hemangioma with Kasabach–Merritt syndrome

Cited by 24 publications

References 19 publications

The impact of tumor progesterone receptor status on optimal adjuvant endocrine therapy for postmenopausal patients with early‐stage breast cancer

The impact of tumor progesterone receptor status on optimal adjuvant endocrine therapy for postmenopausal patients with early‐stage breast cancer

Clinical Review: Management of Adult Kasabach-Merritt Syndrome Associated with Hemangiomas

Clinical analysis of kasabach-merritt syndrome in 17 neonates

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