Bleomycin A5 plus dexamethasone for control of growth in infantile parotid hemangiomas

Objective The purpose of this study was to evaluate the efficacy of bleomycin A5 (pingyangmycin) plus dexamethasone for control of growth in infantile parotid hemangiomas. Study design We reviewed and analyzed the data of 31 cases undergoing therapy of intralesional injection with small-dosage and low-concentration bleomycin A5 plus dexamethasone between June 2004 and October 2007. Clinical manifestations, image characteristics, and therapeutic outcomes were reviewed. The therapeutic outcomes were evaluated by physical examination, photographs, and Doppler ultrasonography. The follow-up was from 6 months to 3 years after ending treatment. Results Twenty-five patients (80.6%) had a response rate greater than 90% reduction in tumor size. Three patients (9.7%) had a response rate between 75% and 90% reduction in tumor size. Another 3 patients (9.7%) had a response rate between 50% and 75% reduction in size. No patients had less than a 50% response rate. There was no recurrence, allergic reaction, pulmonary fibrosis, fever, or other complication during or after the course of treatment. Conclusions The controlling therapy with small-dosage and low-concentration bleomycin A5 plus dexamethasone can treat the parotid hemangiomas of infants effectively, especially for lesions in the early phase and proliferative phase. Early control and long-term observation are the key aspects of treatment.