Photodynamic therapy in AIDS-related cutaneous Kaposi's sarcoma.
For evaluating the role of photodynamic therapy (PDT) in the local treatment of acquired immune deficiency syndrome (AIDS)-related cutaneous Kaposi's sarcoma (KS), nine treatments were performed in eight human immunodeficiency virus-positive homosexual men. The patients received 2 mg Photofrin/kg and either 120 J/cm2 (n = 5) or 70 J/cm2 (n = 4) laser light (630 nm). A total of 83 lesions were evaluable for response with a follow-up of 3-8 months. The overall response rates by patient for all treated lesions were 50-100% (120 J/cm2) and 83.3-90.3% (70 J/cm2), with a median duration of 3 months (range, 2-6 months). Tumors located at the head had higher response rates than those at the trunk or extremities (p = 0.005 and p - 0.015 respectively). The size of the KS showed a negative relationship with the probability of complete response (p = 0.047). Local and general side effects occurred, including pain, blisters, temperature increase, muscle stiffness, and severe edema. The cosmetic result was unsatisfactory because of a high prevalence of scars and long-lasting hyperpigmentation. Although the response rates of PDT are high, light dose of 70-120 J/cm2 cannot be recommended in the treatment of cutaneous KS in combination with 2 mg/kg Photofrin because of severe side effects and unsatisfactory cosmetic result.
Hebeda
K M
KM
Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands.
Huizing
M T
MT
Brouwer
P A
PA
van der Meulen
F W
FW
Hulsebosch
H J
HJ
Reiss
P
P
Oosting
J
J
Veenhof
C H
CH
Bakker
P J
PJ
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D002921:Cicatrix; D017324:Hematoporphyrin Derivative / Q000627:therapeutic use*; D006801:Humans; D017495:Hyperpigmentation; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000009:adverse effects / Q000379:methods*; D012514:Sarcoma, Kaposi / Q000532:radiotherapy*; D012878:Skin Neoplasms / Q000532:radiotherapy*; D016896:Treatment Outcome
D017324:Hematoporphyrin Derivative