Yudai Goto1, Michitoshi Yamashita2, Keiichi Kakuta2, Kakeru Mahchino2, Seiya Ogata2, Kotaro Mimori2, Hirofumi Shimizu2, Hideaki Tanaka3. 1. Department of Pediatric Surgery, Fukushima Medical University Hospital, Fukushima, Japan; Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan. 2. Department of Pediatric Surgery, Fukushima Medical University Hospital, Fukushima, Japan. 3. Department of Pediatric Surgery, Fukushima Medical University Hospital, Fukushima, Japan. Electronic address: tanaka-h@fmu.ac.jp.
Abstract
BACKGROUND: Eppikajutsuto (TJ-28) is an herbal medicine recently reported to be effective in treating lymphatic malformations (LMs). We report our experience concerning the clinical efficacy of TJ-28 for LMs. METHODS: Medical records of 10 LM cases treated with TJ-28 between 2016 and 2018 were reviewed. TJ-28 was given at 0.3 g/kg/day and then increased to 0.5 if no improvement was noted after the first three months of treatment. Their clinical data were collected, and LM volume indices (depth×width×height) were measured with the first (LMVI-F) and latest (LMVI-L) imaging studies. The response rates were calculated as 1-LMVI-L / LMVI-F (%). RESULTS: The median age at the diagnosis and treatment period was 1.5 years and 17.5 months, respectively. LMs were located in the neck (six), mesenterium or retroperitoneum (three), and inguinal region (one). The median response rate was 83%, including 100% in three cases and the apparent improvement of obstructive airway symptoms in one case. One case underwent surgery for insufficient improvement, and another that showed no effect is being considered for surgery. Most of the satisfactory outcomes were demonstrated in the first six months of treatment. CONCLUSION: TJ-28 seems to be effective in treating LMs in children, especially early in treatment. LEVEL OF EVIDENCE: IV.
BACKGROUND: Eppikajutsuto (TJ-28) is an herbal medicine recently reported to be effective in treating lymphatic malformations (LMs). We report our experience concerning the clinical efficacy of TJ-28 for LMs. METHODS: Medical records of 10 LM cases treated with TJ-28 between 2016 and 2018 were reviewed. TJ-28 was given at 0.3 g/kg/day and then increased to 0.5 if no improvement was noted after the first three months of treatment. Their clinical data were collected, and LM volume indices (depth×width×height) were measured with the first (LMVI-F) and latest (LMVI-L) imaging studies. The response rates were calculated as 1-LMVI-L / LMVI-F (%). RESULTS: The median age at the diagnosis and treatment period was 1.5 years and 17.5 months, respectively. LMs were located in the neck (six), mesenterium or retroperitoneum (three), and inguinal region (one). The median response rate was 83%, including 100% in three cases and the apparent improvement of obstructive airway symptoms in one case. One case underwent surgery for insufficient improvement, and another that showed no effect is being considered for surgery. Most of the satisfactory outcomes were demonstrated in the first six months of treatment. CONCLUSION: TJ-28 seems to be effective in treating LMs in children, especially early in treatment. LEVEL OF EVIDENCE: IV.