Intralesional chemotherapy

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Two uncontrolled phase II studies have examined the effect of treating intraoral, oropharyngeal and laryngeal AIDS-related KS by intralesional injection of vinblastine.16,17 One obtained a 62% complete response rate (16/26 lesions) in 24 patients with AIDS-associated oropharyngeal or laryngeal KS.16 Lesions were injected with vinblastine, 0-1-0-2 mg/ml repeated "every 4 to 5 weeks" until complete response or stable disease. Side-effects included self-limiting pain, and ulceration. In 11 of 24 patients the pain was not relieved by paracetamol. A similarly high complete response rate was found in another uncontrolled phase II study of intralesional vinblastine as a local treatment for oral-cavity AIDS-associated KS.17 A total of 144 lesions in 50 patients were treated, and the complete response rate was 74%. The most common site of intraoral KS is the hard palate. Intralesional chemotherapy (vinblastine, vincristine or bleomycin) has also been used to treat cutaneous KS lesions, with overall response rates (complete response plus partial response) in small uncontrolled studies of 88-100%.1819

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