Treatment Options No Longer Considered Effective for Childhood LCH

Treatments that have been used in the past but are no longer recommended for pediatric patients with LCH include cyclosporine [163] and interferon-alpha.[164]

Extensive surgery is also not indicated. For lesions of the mandible, extensive surgery may destroy any possibility of secondary tooth development. Surgical resection of groin or genital lesions is contraindicated because these lesions can be healed by chemotherapy.

Radiation therapy use in LCH has been significantly reduced in pediatric patients, and even low-dose radiation therapy should be limited to single-bone, vertebral body lesions or other single-bone lesions compressing the spinal cord or optic nerve that do not respond to chemotherapy or are painful and not amenable to other therapy.[94,101,165]