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Retrospective Study
Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Pediatr. Sep 9, 2026; 15(3): 119506
Published online Sep 9, 2026. doi: 10.5409/wjcp.119506
Sirolimus for the treatment of vascular tumors and malformations in children: A 10-year single-institution retrospective study
Chane Choed-Amphai, Pimlak Charoenkwan, Rungrote Natesirinilkul, Supawadee Maneekesorn, Supapitch Chanthong, Wipawee Morakote, Lalita Sathitsamitphong, Nattaporn Thongngam
Nattaporn Thongngam, Lalita Sathitsamitphong, Supapitch Chanthong, Supawadee Maneekesorn, Rungrote Natesirinilkul, Pimlak Charoenkwan, Chane Choed-Amphai, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Lalita Sathitsamitphong, Supapitch Chanthong, Supawadee Maneekesorn, Rungrote Natesirinilkul, Pimlak Charoenkwan, Chane Choed-Amphai, Thalassemia and Hematology Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Wipawee Morakote, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Author contributions: Thongngam N and Choed-Amphai C contributed to conceptualization, methodology, and statistical analysis; Thongngam N contributed to data collection and writing; Morakote W contributed to data collection and radiologic review; Choed-Amphai C contributed to supervision, reviewing, and editing; Sathitsammitpong L, Chanthong S, Manikasorn S, Netsirinilkul R, and Charoenkwan P contributed to methodology, reviewing, and editing; and all authors contributed to the article and approved the submitted version.
Institutional review board statement: This study was approved by the Institutional Review Board/Ethics Committee of the Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand (approval No. PED-2568-0835).
Informed consent statement: The requirement for written informed consent was waived by the Institutional Review Board/Ethics Committee of the Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, due to the retrospective nature of the study and the use of de-identified data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
Corresponding author: Chane Choed-Amphai, MD, PhD, Assistant Professor, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, No. 110 Intawarorot Road, Sriphum, Muang, Chiang Mai 50200, Thailand. chane.c@cmu.ac.th
Received: January 30, 2026
Revised: March 13, 2026
Accepted: April 15, 2026
Published online: September 9, 2026
Processing time: 183 Days and 13.5 Hours
Core Tip

Core Tip: Sirolimus is increasingly used as targeted therapy for pediatric vascular anomalies, yet real-world clinical data remain limited. In this retrospective study of children with vascular tumors and malformations, sirolimus demonstrated a high response rate and an acceptable safety profile across diverse disease subtypes. Rapid resolution of Kasabach-Merritt phenomenon was observed in patients with kaposiform hemangioendothelioma receiving combination therapy. However, disease progression occurred after treatment discontinuation, highlighting the need for careful post-therapy monitoring. These findings support sirolimus as an effective treatment option in refractory or unresectable pediatric vascular anomalies and emphasize the importance of optimizing treatment duration and follow-up strategies.

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