Palliative treatment for HIV-related Kaposi's sarcoma

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dc.contributor.authorBarnardt P.
dc.contributor.authorGeorgiev G.D.
dc.date.accessioned2011-05-15T16:18:11Z
dc.date.available2011-05-15T16:18:11Z
dc.date.issued2003
dc.description.abstractObjective. To evaluate palliative treatment with chemotherapy and/or radiotherapy in patients with HIV-related Kaposi's sarcoma (KS). The primary end-point was symptom relief; the secondary end-point was tumour response to treatment and overall survival. Methods. This study includes 100 patients with HIV-related KS. Combination chemotherapy was administered with ABV (doxorubicin, bleomycin and vincristine) (33 patients), or vinblastine and bleomycin (Vbl-B) (48 patients), depending on the CD4+ count at presentation. Radiotherapy was administered to 31 patients. Results. Symptomatic relief was noted within 4 weeks of chemotherapy and response after 8 weeks. Twenty-nine patients (29%) had partial responses, 8 patients (8%) achieved complete responses, and 37 patients (37%) had stable disease. Twenty-six patients (26%) had disease progression. The response rate was 37%, with clinical benefit achieved in 74% of patients. Patients who received radiation therapy for bleeding and painful ulcers had complete responses. Twenty-seven patients (27%) received 8 Gray (Gy) single fractions. Two lower-half bodies (8 Gy) and one upper-half body (6 Gy) were irradiated. Five patients received a course of radiation for nasopharyngeal and skeletal lesions (20 Gy), rectal lesions (30 Gy) and an eyelid lesion (12 Gy). Forty-two patients (42%) are alive, with a median survival of 11.2 months (range 2 - 49 months). Fifty-eight patients (58%) died due to progression of HIV disease or associated opportunistic infections with a median overall survival of 8.8 months (range 1 - 31 months). Conclusion. In the absence of antiretroviral therapy the care and prognosis of HIV-related Kaposi's sarcoma remains dismal. However, symptomatic relief and an improved quality of life can still be offered.
dc.description.versionArticle
dc.identifier.citationSouthern African Journal of HIV Medicine
dc.identifier.citation13
dc.identifier.issn16089693
dc.identifier.urihttp://hdl.handle.net/10019.1/14546
dc.subjectanthracycline derivative
dc.subjectantiretrovirus agent
dc.subjectbleomycin
dc.subjectCD4 antigen
dc.subjectcotrimoxazole
dc.subjectdoxorubicin
dc.subjectpaclitaxel
dc.subjectproteinase inhibitor
dc.subjectvinblastine
dc.subjectvincristine
dc.subjectacquired immune deficiency syndrome
dc.subjectadult
dc.subjectarticle
dc.subjectbleeding
dc.subjectblood toxicity
dc.subjectcancer chemotherapy
dc.subjectcancer growth
dc.subjectcancer mortality
dc.subjectcancer staging
dc.subjectcancer survival
dc.subjectcontrolled study
dc.subjectdrug choice
dc.subjectdrug response
dc.subjectdrug tolerability
dc.subjectfemale
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectKaposi sarcoma
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectneutropenia
dc.subjectopportunistic infection
dc.subjectpalliative therapy
dc.subjectPneumocystis pneumonia
dc.subjectprognosis
dc.subjectradiation dose
dc.subjectulcer
dc.titlePalliative treatment for HIV-related Kaposi's sarcoma
dc.typeArticle
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