Infantile hemangiomas (IH) represent the most prevalent vascular tumors in infants, often necessitating prompt medical intervention due to their potential for rapid growth and complications. This retrospective study aims to evaluate the efficacy of propranolol combined with Pingyangmycin in the treatment of IH and to investigate its correlation with vascular endothelial growth factor (VEGF) levels.

A prospective, observational study was conducted over 12 months, enrolling 120 IH patients. Patients received a combination therapy of propranolol and pingyangmycin for 3 to 6 months. Hemangioma Activity Score (HAS) and serum VEGF levels were assessed at baseline, 30th day, and 90th day post-treatment.

A total of 120 patients diagnosed with IH, including 68 males and 52 females with a mean age of 1.2 years, were enrolled in this study. The HAS at baseline was 8.5 ± 1.7, which significantly decreased to 4.2 ± 1.0 by Day 30 and further reduced to 2.1 ± 0.8 by Day 90 (P < 0.001 for both comparisons). Serum VEGF levels also showed a significant reduction from a baseline of 235.6 ± 42.1 pg/mL to 180.3 ± 34.7 pg/mL at Day 30 and to 122.8 ± 28.9 pg/mL at Day 90 (P = 0.02 and P = 0.01, respectively). The correlation analysis revealed a positive correlation between VEGF levels and HAS scores at all time points, with Pearson correlation coefficients ranging from -0.82 to -0.89 (P < 0.001). Adverse events were mild and transient, occurring in 15 % of patients, with the most common being mild hypoglycemia (8 %), transient bronchospasm (5 %), and gastrointestinal discomfort (2 %). All adverse events resolved with symptomatic treatment, and no patient discontinued therapy due to adverse reactions.

Propranolol treatment for infants with proliferative hemangiomas is significantly effective with minor adverse effects. The mechanism of action may be associated with the downregulation of serum VEGF levels.