Abstract

HERNANDEZ, Dimas E; MUCI-MENDOZA, Rafael  and  COMEGNA, Mario. Sarcoma de Kaposi asociado a VIH: Uso de doxorrubina loposomal terapia antirretroviral de alta eficicencia. Rev. venez. oncol. [online]. 2011, vol.23, n.1, pp.14-20. ISSN 0798-0582.

At present there are no defined criteria for treating Kaposi´s sarcoma associated with HIV in the era of highly active antiretroviral therapy. Evidence of regression of cutaneous lesions with only retroviral high efficacy therapy without need of chemotherapy; nevertheless, it is very unlikely that visceral or mucous lesions respond to retroviral without simultaneous initiation chemotherapy. OBJECTIVE: Prospective study in “low risk” and “high risk” Kaposi patients, trying to define the adequate moment for initiating the chemotherapy simultaneously with retroviral. METHOD: 66 male Kaposi patients, 28(42 %) T0I0S0, 6 (9 %) T0I0S1, 8 (12 %) T0I1S1, 5 (8 %) T1I1S0 y 19 (29 %) T1I1S1. All T1, T0I1S1 and a third of T0I0S1 patients were treated with chemotherapy (4 to 8 cycles with liposomal doxorubicin) but none of the T0I0S0 patients. RESULTS: 34 clinical responses, 6 (18) complete (3 T1I1S1, 2 T1I1S0, and 1 T0I1S1), 23 (68 %) partial (16 T1I1S1, 3 T1I1S0, 3 T0I1S1, and 1 T0I0S1) and 5 (14 %) stable disease (T0I1S1). CONCLUSIONS: All patients with extensive tumors require chemotherapy administration since the moment of diagnosis, together with retroviral high efficacy agents. Patients with localized tumors, CD4 cell levels ≤ 200 /μL), and systemic symptoms will require chemotherapy in approximately 2 to 3 months period after initiation of retroviral, while none of patients with localized tumors, without systemic symptoms, and CD4 cell levels > 200 /μL will require chemotherapy, at least in a mean 20 months follow-up period.

Keywords : Sarcoma; Kaposi; sarcoma; treatment; liposomal doxorubicin; antiretroviral.