Treatment of kaposiform hemangioendothelioma and tufted angioma

Abstract

This meta-analysis was to evaluate the efficacy of current treatment modalities for kaposiform hemangioendothelioma and tufted angioma. A systematic review was performed using PubMed (Medline), Web of Science and Embase for clinical studies. The outcome was measured by pooled response rate with 95% confidence intervals (CIs), together with heterogeneity, subgroup analysis, sensitivity analysis and publication bias. Fifteen studies with 244 participants were included in this analysis. Vincristine therapy exhibited a relatively higher response rate (0.72; 95%CI, 0.64–0.79) compared with other therapies including systemic corticosteroid (0.27; 95%CI, 0.17–0.36), interferon (0.36; 95%CI, 0.24–0.48), radiotherapy (0.49; 95%CI, 0.26–0.73), embolization (0.66; 95%CI, 0.48–0.83), aspirin/ticlopidine (0.42; 95%CI, 0.06–0.78) and sirolimus (0.57; 95%CI, 0.00–0.10), in treating KHE/TA. Subgroup analysis indicated that the efficacy of systemic corticosteroids therapy was age-related. The pooled response rate was 0.15 (95%CI, 0.08–0.23) for participants 3.5 months of age and older compared with 0.35 (95% CI, 0.26–0.44) for participants less than 3.5 months. Regarding side effects, systemic corticosteroids treatment was 0.32 (95%CI, 0.15–0.50), vincristine modality was 0.16 (95%CI, 0.08–0.24) and interferon therapy was 0.28 (95%CI, 0.13–0.43). In conclusion, as one of the first reviews evaluating the effect of common therapies in the treatment of KHE/TA, our meta-analysis displayed that vincristine was more effective. Thus, vincristine was the most effective, providing evidence supporting the use of vincristine as a first-line therapy for KHE/TA.