Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
TREATMENT OF KAPOSI'S SARCOMA
Aids and Infections of Homosexual Men. Second Edition. Ma P and Armstrong D, eds. Boston, Butterworths, p. 355-70 1989.. Unique Identifier : AIDSLINE ICDB/90659649 Myskowski PL; Safai B; Cornell Univ. Medical Coll., New York, NY
Abstract:
Four types of Kaposi's sarcoma (KS) have been recognized: classic KS, African KS, KS in immunocompromised individuals, and KS in AIDS. Although the types of KS share a common histology, the important differences in clinical course and complicating factors (eg, opportunistic infections) have mandated varied treatment approaches. Treatment of KS is reviewed, including radiotherapy, chemotherapy (Vinca alkaloids, dactinomycin, bleomycin, 1,3-bis[2-chloroethyl]-1-nitrosourea, dimethyl-imidazole-triazeno-carboxamide), immune stimulation with biologic response modifiers (interferons), and miscellaneous drugs (dapsone, isotretinoin, and isoprinosine). Therapy of classic KS consists primarily of local control of disease, often through the use of radiation therapy but occasionally through chemotherapy. In contrast, AIDS-associated KS is an aggressive neoplasm that poses a special problem. Effective tumor control may be crucial because disseminated disease can be life-threatening, but the primary limiting factor is the severe immunosuppression induced by HIV. Some chemotherapeutic regimens and the use of biologic response modifiers, especially alpha-IFN, have proven useful in treating patients with AIDS-associated KS. Radiation therapy may provide important palliation of cutaneous tumors. The future direction of therapy against KS and AIDS likely will involve the use of antiviral agents, probably in conjunction with some immune reconstitution. Most exciting of the anti-HIV drugs is azidothymidine. Ribavirin also has shown promise in vitro against HIV. Some studies have suggested that ribavirin therapy can reduce HIV activity in peripheral blood lymphocyte cultures. Interferon also inhibits HIV replication in vitro, which may account for some of its effectiveness in the treatment of AIDS-associated KS. In addition, antiviral agents such as phosphonoformate are entering clinical trials and may prove to have some activity against HIV. (72 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS Antineoplastic Agents/THERAPEUTIC USE Antineoplastic Agents, Combined/THERAPEUTIC USE Biological Response Modifiers/THERAPEUTIC USE Combined Modality Therapy *Homosexuality Human Male Sarcoma, Kaposi's/DRUG THERAPY/RADIOTHERAPY/*THERAPY Skin Neoplasms/DRUG THERAPY/RADIOTHERAPY/*THERAPY MONOGRAPH REVIEW REVIEW, TUTORIAL 900430
M9040661
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Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
