Intralesional vinblastine for cutaneous Kaposi's sarcoma associated with acquired immunodeficiency syndrome. A clinical trial to evaluate efficacy and discomfort associated with infection.
BACKGROUND
Intralesional vinblastine has been used to treat Kaposi's sarcoma associated with acquired immunodeficiency syndrome (AIDS-KS). Injections are painful and anticipated response rates are not well documented.


OBJECTIVE
Eleven homosexual men were studied to evaluate the efficacy and pain associated with intralesional vinblastine with or without 1% bicarbonate buffered lidocaine (BBL).


METHODS
Six lesions on each patient were selected and treated with either vinblastine, vinblastine mixed with BBL, or vinblastine 5 minutes after BBL injection. Control lesions received BBL, saline, or no treatment. Patients recorded injection pain on a visual analog scale.


RESULTS
There was a complete or partial clinical response in 88% of vinblastine-treated lesions. Pain scores for BBL, vinblastine, and the mixture of BBL and vinblastine were not statistically different.


CONCLUSIONS
Intralesional vinblastine is effective therapy for AIDS-KS. Local anesthesia does not reduce efficacy of treatment, or reduce the pain experienced by the patient.
Department of Dermatology, University of California, San Francisco.
A A
AA
Boudreaux
L L
LL
Smith
C D
CD
Cosby
M M
MM
Bason
J W
JW
Tappero
T G
TG
Berger
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001639:Bicarbonates / Q000008:administration & dosage; D002021:Buffers; D006801:Humans; D015552:Injections, Intralesional / Q000009:adverse effects; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D010146:Pain / Q000209:etiology* / Q000517:prevention & control; D012514:Sarcoma, Kaposi / Q000188:drug therapy* / Q000209:etiology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000209:etiology; D012964:Sodium / Q000008:administration & dosage; D017693:Sodium Bicarbonate; D014747:Vinblastine / Q000008:administration & dosage* / Q000009:adverse effects
D001639:Bicarbonates; D002021:Buffers; D014747:Vinblastine; D017693:Sodium Bicarbonate; D008012:Lidocaine; D012964:Sodium