Fardet Laurence, Stoebner Pierre-Emmanuel, Bachelez Herve, Descamps Vincent, Kerob Delphine, Meunier Laurent, Dandurand Michel, Morel Patrice, Lebbe Celeste
Department of Dermatology, Hospital Saint-Louis, Paris, France.
Cancer. 2006 Apr 15;106(8):1785-9. doi: 10.1002/cncr.21791.
Kaposi sarcoma (KS) is an angioproliferative disease that may represent a difficult therapeutic challenge in disseminated stages. The efficacy of taxanes (paclitaxel and docetaxel), as agents with antiangiogenic properties, has been described previously in the treatment of patients with acquired immunodeficiency syndrome (AIDS)-associated KS but remains unknown in the treatment of patients with refractory or life-threatening KS without human immunodeficiency (HIV) infection.
During the past 6 years, 12 non-HIV-infected patients with refractory KS were treated with paclitaxel (175 mg/m2 every 3 wks) or docetaxel (60 mg/m2 every 3 wks).
All patients improved dramatically after chemotherapy. Partial desinfiltration (n = 6) or complete desinfiltration (n = 6) of all papulonodular skin lesions was observed with marked improvement of lymphedema in 6 patients. According to the AIDS Clinical Trials Group criteria, response was partial in 100% of patients. A major response was obtained among patients who had visceral lesions (n = 3 patients), with rapid and complete remission of digestive or respiratory symptoms. The mean delay to response was 2 courses. Treatment was sustained for 3 patients. For the remaining 9 patients who received a median of 7 courses (range, 2-14 courses), the mean time to recurrence or follow-up without recurrence was 13 months. Tolerance was good except for 3 episodes of Grade 3 or 4 asymptomatic neutropenia and 1 episode of moderate myositis.
The results of this study showed that taxanes are beneficial in the treatment of patients with refractory or life-threatening Kaposi sarcoma.
卡波西肉瘤（KS）是一种血管增殖性疾病，在播散期可能是一个难以治疗的挑战。紫杉烷类药物（紫杉醇和多西他赛）具有抗血管生成特性，此前已报道其在治疗获得性免疫缺陷综合征（AIDS）相关KS患者中的疗效，但在治疗无人类免疫缺陷病毒（HIV）感染的难治性或危及生命的KS患者中的疗效尚不清楚。
在过去6年中，12例非HIV感染的难治性KS患者接受了紫杉醇（每3周175mg/m²）或多西他赛（每3周60mg/m²）治疗。
所有患者化疗后均有显著改善。观察到所有丘疹结节性皮肤病变部分消退（n = 6）或完全消退（n = 6），6例患者的淋巴水肿明显改善。根据AIDS临床试验组标准，100%的患者有部分反应。在内脏病变患者（n = 3例）中获得了主要反应，消化或呼吸道症状迅速完全缓解。平均反应延迟为2个疗程。3例患者持续接受治疗。其余9例患者接受的疗程中位数为7个疗程（范围为2 - 14个疗程），复发或无复发随访的平均时间为13个月。耐受性良好，除了3次3级或4级无症状中性粒细胞减少发作和1次中度肌炎发作。
本研究结果表明，紫杉烷类药物对治疗难治性或危及生命的卡波西肉瘤患者有益。
