CHEMOTHERAPY FOR AIDS-RELATED AND ENDEMIC AFRICAN KAPOSI'S SARCOMA IN SOUTHERN AFRICA |
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| Authors: | MOSHE E. STEIN M.D. JESSE LACHTER M.D. DAVID SPENCER M.D. WERNER R. BEZWODA Ph .D. |
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| Affiliation: | Northern Israel Oncology Center and the Department of Gastroenterology, Rambam Medical Center and Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel, and the Division of Medical Oncology 8c Clinical Hematology, Johannesburg General Hospital and Faculty of Medicine, University of the Witwatersrand, Johannesburg, R.S.A. |
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| Abstract: | Background. Kaposi's sarcoma (KS), either in its endemic (African) form or its AIDS-related variant, is a common neoplastic disorder seen in Southern Africa. Chemotherapy has been proven to be very effective in advanced or relapsed African Kaposi's sarcoma, but much less so in AIDS-related, endemic KS. Patients and Methods. The study consists of a retrospective analysis of the results of chemotherapy alone in 17 patients with African KS (AKS) and in 32 patients with epidemic AIDS-related KS (EKS), treated at the Johannesburg General Hospital between 1982 and 1992. Single agents included vinblastine, actinomycin D, bleomycin, and vincristine; combined regimens were largely doxorubicin/vincristine/ bleomycin or etoposide/methotrexate. Outcome classifications were: complete remission (CR), partial remission (PR), and treatment failure (TF). Results. Four of the 17 patients with AKS had CR, 10 a PR, and three were TF and died rapidly from their disease. The combined chemotherapeutic regimens produced marked symptomatic relief and even long-term remission in AKS. In patients with EKS, the response rate to chemotherapy was very low and of brief duration. No patient had a CR and debilitating side effects were common. Conclusions. The African type of AKS is a chemo-sensitive tumor, whereas the endemic type EKS, like its Western counterpart, has a dismal prognosis. |
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