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Eur J Pediatr Surg 2019; 29(05): 401-407
DOI: 10.1055/s-0038-1673708
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Comparison of Corticosteroid and Vincristine in Treating Kaposiform Hemangioendothelioma and Tufted Angioma: A Systematic Review and Meta-Analysis

Wei Yao
1   Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, People's Republic of China
,
Kai Li
1   Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, People's Republic of China
,
Zuopeng Wang
1   Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, People's Republic of China
,
Jiahao Pei
1   Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, People's Republic of China
,
Xiangqi Liu
1   Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, People's Republic of China
,
Shan Zheng
1   Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, People's Republic of China
,
Kuiran Dong
1   Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, People's Republic of China
› Author Affiliations
Further Information

Publication History

06 June 2018

30 August 2018

Publication Date:
29 October 2018 (online)

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Abstract

Objective To evaluate the outcome and safety of corticosteroids and vincristine (VCR) in the treatment of kaposiform hemangioendothelioma (KHE) and tufted angioma (TA).

Materials and Methods Clinical studies involving corticosteroids and VCR therapies in treating KHE/TA were identified by using PubMed, Cochrane Library, OVID, EBSCO, CNKI, VIP, and Wanfang databases from their establishment date to December 2017. Randomized controlled trials, case–control, or case series with more than five cases were included. The following data were extracted: study sample, demographics, responses rate, recurrence rate, and adverse reactions. Two reviewers completed screening and extraction. Methodological quality was evaluated with quality appraisal tool.

Results A total of 266 studies were found, and 27 studies were finally included in this research; quality of all studies was low. Seven studies with a total of 123 participants, which compared the effect of systemic corticosteroids with that of VCR, were performed for the meta-analysis. The results indicated that the effect of VCR was significantly higher than that of corticosteroids (relative risk [RR] = 2.08, 95% confidence interval [CI]: 1.38–3.16). The recurrence rate of VCR (11.1%) was lower than that of corticosteroids (50%), but there was no statistical difference between the two therapies (p = 0.1312). The result of pooled adverse reactions response rate for VCR was 18.2%, significantly lower than that for corticosteroids, which was 52.0%.

Conclusion The present profile shows that VCR is relatively more effective and safer in treating KHE/TA than corticosteroids are. So, we believe VCR could be used as a first-line medication agent in the treatment of KHE/TA.

Keywords

kaposiform hemangioendothelioma - tufted angioma - corticosteroids - vincristine - meta-analysis

Note

Informed consent was obtained from all individual participants included in the study.