The efficacy of oral propranolol for 59 children with infantile hemangiomas

Objective:To investigate the efficacy and safety of oral propranolol for infantile hemangiomas.(IH).Methods: 59 patients with IH were included in this study.The propranolol dose was 2.0 mg/kg.d divided BID.Blood pressure and heart rate were monitored one to three hours after taken the medicine per day within the first 3 days.The patients were asked for follow-up visit every month.The size,texture and color of the tumor were taken photoes and a photograph based serverity scoring assessement was performed.The blood pressure,heart rate and blood glucose were measured regularly and the side effect was also recorded.Results: Among 59 IH patients,there were 21 males and 38 females with a mean age of 5.08 months.4 cases are strawberry hemangiomas,8 cavernous hemangiomas and 47 mixed hemangiomas.The lesions were located in extremities(n=10),trunk(n=7),head and neck(n=32).Special locations were perioral and nasal(n=8),orbital(n=l),ulceration(n=2).After 48 hours propranolol treatment,most patients showed decreased skin temperature and darken in color of tumor surface.The average serverity score at 4 and 8 weeks follow-up was 5 and 4 respectively.Which means tumors decreased more than 50% and 60% respectively.No statistical differnences among strawberry,cavernous and mixed types hemangiomas were observed.Efficacy has independence with gender,onset age and location.Propranolol also has conspicuous effect on the lesions perioral and nasal,orbital and ulceration.No symptomatic low blood pressure or hypoglycemia was observed.There was one case of diarrhea,11 cases of sleep disorders.9 of 11 patients were noted to have agitated sleep.2 were observed to have hypersomnia.Conclusion: Oral propranolol therapy is a safe and effective therapeutic regimen for infantile hemangiomas with little side effects.It can be used as the first-line protocol chemotherapy.