Brambilla L, Miedico A, Ferrucci S, Romanelli A, Brambati M, Vinci M, Tedeschi L, Boneschi V
Institute of Dermatological Sciences, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via Pace 9, 20122 Milan, Italy.
J Eur Acad Dermatol Venereol. 2006 Oct;20(9):1090-4. doi: 10.1111/j.1468-3083.2006.01730.x.
Classic KS (CKS) mainly affects elderly people, has an irregular course, and is relatively benign for years. However, sometimes the disease may progress rapidly and spread to internal organs, thus necessitating systemic chemotherapy. We therefore decided to carry out a prospective trial using vinblastine and bleomycin, which are active, easy to administer and control, and low cost.
We treated 29 patients affected by CKS with vinblastine i.v., up to 10 mg in combination with bleomycin i.m., 15 IU every 3 weeks. We administered a median of seven cycles of therapy.
All the 29 enrolled patients were evaluated: 21% reached a complete response and 76% had an intermediate response. Toxicity was limited. The maximal response was attained in a median of 5 months, with a mean duration of 4 months.
The combination of vinblastine and bleomycin achieved a high rate of objective responses in a subgroup of elderly and symptomatic patients, without considerable toxicity. We recommend the combination as first line chemotherapy for advanced CKS.
经典型卡波西肉瘤（CKS）主要影响老年人，病程不规则，多年来相对良性。然而，有时该疾病可能迅速进展并扩散至内脏器官，因此需要进行全身化疗。我们因此决定开展一项使用长春碱和博来霉素的前瞻性试验，这两种药物活性高、易于给药和控制且成本低。
我们用静脉注射长春碱治疗29例CKS患者，剂量高达10毫克，并联合肌肉注射博来霉素，每3周15国际单位。我们给予的中位治疗周期数为7个周期。
对所有29例入组患者进行了评估：21%达到完全缓解，76%有中度缓解。毒性有限。中位5个月达到最大缓解，平均持续时间为4个月。
长春碱和博来霉素联合用药在老年和有症状的患者亚组中取得了较高的客观缓解率，且毒性不大。我们推荐该联合用药作为晚期CKS的一线化疗方案。
