Indiana University School of Medicine, IU Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN 46202, USA.
Oncology. 2010;78(1):5-11. doi: 10.1159/000292356. Epub 2010 Mar 6.
Evaluation of outcomes in the use of single-agent gemcitabine for the treatment of AIDS-associated Kaposi's sarcoma (KS) in a western Kenyan cancer treatment program.
Retrospective chart review of all patients with KS treated with single agent gemcitabine following failure of first-line Adriamycin, bleomycin, and vincristine (ABV). Baseline demographics were collected, and clinicians' assessments of response were utilized to fill out objective criteria for both response as well as symptom benefit assessment.
Twenty-three patients with KS who had previously failed first-line therapy with ABV were evaluated. Following treatment, 22 of the 23 patients responded positively to treatment with stable disease or better. Of the 18 patients who had completed therapy, with a median follow-up of 5 months, 12 patients had no documented progression.
Treatment options in the resource-constrained setting are limited, both by financial constraints as well as the need to avoid myelotoxicity, which is associated with high morbidity in this treatment setting. This work shows that gemcitabine has promising activity in KS, with both objective responses and clinical benefit observed in this care setting. Gemcitabine as a single agent merits further investigation for AIDS-associated KS.
评估在肯尼亚西部癌症治疗项目中，使用单药吉西他滨治疗艾滋病相关卡波西肉瘤（KS）的疗效。
对所有在一线阿霉素、博来霉素和长春新碱（ABV）治疗失败后接受单药吉西他滨治疗的 KS 患者进行回顾性病历审查。收集基线人口统计学数据，并利用临床医生对反应的评估来填写客观标准，以评估反应和症状改善。
评估了 23 例先前接受 ABV 一线治疗失败的 KS 患者。治疗后，23 例患者中有 22 例对治疗有积极反应，表现为疾病稳定或更好。在完成治疗的 18 例患者中，中位随访 5 个月，12 例患者无疾病进展记录。
在资源有限的环境中，治疗选择既受到经济限制的影响，也受到避免与该治疗环境中高发病率相关的骨髓抑制的需要的限制。这项工作表明，吉西他滨在 KS 中具有有前途的活性，在这种治疗环境中观察到客观反应和临床获益。单药吉西他滨值得进一步研究用于治疗艾滋病相关 KS。
