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Safety and efficacy of intralesional steroid injection for aggressive fibromatosis

BACKGROUND: Treatment of recurrent aggressive fibromatosis (AF) following surgical resection is a clinical challenge. Non-steroidal anti-inflammatory drugs (NSAIDs) have been reported to be an effective option for controlling the disease. However, long-term NSAID use can result in unfavorable compli...

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Autores principales: Pruksakorn, Dumnoensun, Lorsomradee, Sratwadee, Phanphaisarn, Areerak, Teeyakasem, Pimpisa, Klangjorhor, Jeerawan, Chaiyawat, Parunya, Kosachunhanun, Natapong, Settakorn, Jongkolnee, Arpornchayanon, Olarn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667493/
https://www.ncbi.nlm.nih.gov/pubmed/29096658
http://dx.doi.org/10.1186/s12957-017-1262-9
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author Pruksakorn, Dumnoensun
Lorsomradee, Sratwadee
Phanphaisarn, Areerak
Teeyakasem, Pimpisa
Klangjorhor, Jeerawan
Chaiyawat, Parunya
Kosachunhanun, Natapong
Settakorn, Jongkolnee
Arpornchayanon, Olarn
author_facet Pruksakorn, Dumnoensun
Lorsomradee, Sratwadee
Phanphaisarn, Areerak
Teeyakasem, Pimpisa
Klangjorhor, Jeerawan
Chaiyawat, Parunya
Kosachunhanun, Natapong
Settakorn, Jongkolnee
Arpornchayanon, Olarn
author_sort Pruksakorn, Dumnoensun
collection PubMed
description BACKGROUND: Treatment of recurrent aggressive fibromatosis (AF) following surgical resection is a clinical challenge. Non-steroidal anti-inflammatory drugs (NSAIDs) have been reported to be an effective option for controlling the disease. However, long-term NSAID use can result in unfavorable complications. This study was a trial of the use of intralesional steroid injection (ILSI) including investigation of safety margins and clinical outcomes of high-dose steroids for local use treatment of AF. METHODS: A prospective cohort study was conducted to evaluate the safety and efficacy of particulate corticosteroids for AF. Intralesional steroid injections of Kanolone® guided by ultrasound were given monthly for three consecutive months with 1 mg/kg/episode (a total of 3 mg/kg). Patients were followed up monthly for 3 months at the time of each monthly injection and then for an additional 3 months after the last injection. Complications from the procedure and clinical outcomes were monitored. RESULTS: Eight recurrent AF patients completed the full 6-month evaluation process. No procedure-related complications were reported either during the injection period or the follow-up period. None of the patients developed Cushingoid features. The highest number of complication events, all of which were mild or detectable only by laboratory analysis, occurred during the month following the second injection. Triamcinolone levels were significantly increased 24 h after injection, and four of the eight cases developed hypothalamic-pituitary-axis suppression. Tumors were stabilized in 83.3% of the cases during the study period, and pain and functional ability scores improved significantly. CONCLUSIONS: Intralesional steroid injection appears to be a safe and effective alternative treatment for recurrent AF. TRIAL REGISTRATION: TCTR20150409001; Registered date: 9 April 2015; The safety and result of intratumoral steroid injection for aggressive fibromatosis. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12957-017-1262-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-56674932017-11-08 Safety and efficacy of intralesional steroid injection for aggressive fibromatosis Pruksakorn, Dumnoensun Lorsomradee, Sratwadee Phanphaisarn, Areerak Teeyakasem, Pimpisa Klangjorhor, Jeerawan Chaiyawat, Parunya Kosachunhanun, Natapong Settakorn, Jongkolnee Arpornchayanon, Olarn World J Surg Oncol Research BACKGROUND: Treatment of recurrent aggressive fibromatosis (AF) following surgical resection is a clinical challenge. Non-steroidal anti-inflammatory drugs (NSAIDs) have been reported to be an effective option for controlling the disease. However, long-term NSAID use can result in unfavorable complications. This study was a trial of the use of intralesional steroid injection (ILSI) including investigation of safety margins and clinical outcomes of high-dose steroids for local use treatment of AF. METHODS: A prospective cohort study was conducted to evaluate the safety and efficacy of particulate corticosteroids for AF. Intralesional steroid injections of Kanolone® guided by ultrasound were given monthly for three consecutive months with 1 mg/kg/episode (a total of 3 mg/kg). Patients were followed up monthly for 3 months at the time of each monthly injection and then for an additional 3 months after the last injection. Complications from the procedure and clinical outcomes were monitored. RESULTS: Eight recurrent AF patients completed the full 6-month evaluation process. No procedure-related complications were reported either during the injection period or the follow-up period. None of the patients developed Cushingoid features. The highest number of complication events, all of which were mild or detectable only by laboratory analysis, occurred during the month following the second injection. Triamcinolone levels were significantly increased 24 h after injection, and four of the eight cases developed hypothalamic-pituitary-axis suppression. Tumors were stabilized in 83.3% of the cases during the study period, and pain and functional ability scores improved significantly. CONCLUSIONS: Intralesional steroid injection appears to be a safe and effective alternative treatment for recurrent AF. TRIAL REGISTRATION: TCTR20150409001; Registered date: 9 April 2015; The safety and result of intratumoral steroid injection for aggressive fibromatosis. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12957-017-1262-9) contains supplementary material, which is available to authorized users. BioMed Central 2017-11-02 /pmc/articles/PMC5667493/ /pubmed/29096658 http://dx.doi.org/10.1186/s12957-017-1262-9 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Pruksakorn, Dumnoensun
Lorsomradee, Sratwadee
Phanphaisarn, Areerak
Teeyakasem, Pimpisa
Klangjorhor, Jeerawan
Chaiyawat, Parunya
Kosachunhanun, Natapong
Settakorn, Jongkolnee
Arpornchayanon, Olarn
Safety and efficacy of intralesional steroid injection for aggressive fibromatosis
title Safety and efficacy of intralesional steroid injection for aggressive fibromatosis
title_full Safety and efficacy of intralesional steroid injection for aggressive fibromatosis
title_fullStr Safety and efficacy of intralesional steroid injection for aggressive fibromatosis
title_full_unstemmed Safety and efficacy of intralesional steroid injection for aggressive fibromatosis
title_short Safety and efficacy of intralesional steroid injection for aggressive fibromatosis
title_sort safety and efficacy of intralesional steroid injection for aggressive fibromatosis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667493/
https://www.ncbi.nlm.nih.gov/pubmed/29096658
http://dx.doi.org/10.1186/s12957-017-1262-9
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