Therapeutic strategies for epidemic Kaposi's sarcoma

Abstract

Kaposi's sarcoma (KS) remains the most commonly diagnosed malignancy in HIV-infected patients, and is one of the AIDS-defining diagnoses. Several different therapeutic options are available, but the optimal therapy is still unclear. The incidence of KS has sharply declined since highly active antiretroviral therapy (HAART) became widely available, making HAART indispensable in the treatment of epidemic KS. HAART can be given alone or in combination with systemic and local therapy. Systemic therapy can be given in disseminated, progressive or symptomatic disease. Treatment options are interferon-alpha and chemotherapy including pegylated-liposomal anthracyclines and paclitaxel. For local disease, radiotherapy, intralesional chemotherapy or cryotherapy may be used. In resource-limited settings, intravenous vincristine, oral etoposide or intramuscular bleomycin may be feasible options. Other therapies, such as angiogenesis inhibitors, are under investigation in clinical trials.

Sarcoma de Kaposi clássico fatal

“…13 For localized lesions, surgical excision, cryotherapy and radiotherapy may be used. For larger skin lesions, multiple lesions or those affecting internal organs, systemic therapy may be indicated.…”

Critical appraisal of volumetric-modulated arc therapy compared with electrons for the radiotherapy of cutaneous Kaposi’s sarcoma of lower extremities with bone sparing

“…Kaposi's sarcoma (KS) is frequently demonstrated in patients infected by human immunodeficiency virus (HIV)( [1], epidemic form) and can be manifested in the mouth, lymphatic system, gastro-intestinal system, lungs and skin. KS can be considered as generally responsive to radiation therapy, and good palliative (and cosmetic) results were demonstrated with doses higher than 20 Gy [2][3][4].…”

Evaluation of treatment plans using various treatment techniques for the radiotherapy of cutaneous Kaposi's sarcoma developed on the skin of feet

“…The epidemic form of KS is frequently demonstrated in patients infected by human immunodeficiency virus (2) . Even though the percentage of acquired immune deficiency syndrome (AIDS) patients with KS is decreasing, the overall incidence of epidemic KS is increasing along with the rising prevalence of AIDS (3) .…”

“…Even though the percentage of acquired immune deficiency syndrome (AIDS) patients with KS is decreasing, the overall incidence of epidemic KS is increasing along with the rising prevalence of AIDS (3) . It has been well established that KS is responsive to radiation therapy, and in response various radiation treatment schemes have been studied 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 . The response rate of KS in epidemic form to radiation therapy has been demonstrated to be as high as 90%, and it has been proven that radiation therapy shows better symptomatic control than chemotherapy (14) …”