In one uncontrolled phase I/II study of 348 AIDS-related KS lesions in 25 patients treated with
Photofrin photodynamic therapy, the maximum tolerated 630 nm light dose was determined to be 300 J/cm2 if given with Photofrin, 1-0 mg/kg, 48 hours beforehand.13 Of 289 evaluable lesions, 33% had a complete clinical response and 63% had a partial response. At light doses of 400 J/cm2, full-field necrosis and scabbing occurred whereas at doses of 250 J/cm2 side-effects were erythema and oedema within the treatment field. In another uncontrolled phase II study, Photofrin, 2 mg/kg, with 70-120 J/cm2 of 630 nm light therapy for the treatment of 83 evaluable lesions in eight homosexual men with AIDS-related cutaneous KS resulted in high overall response rates (83-100%). However, acute toxicity was unacceptable and the long-term cosmetic result was poor, with scarring and hyperpigmentation.14 A further small uncontrolled phase II study treated 30 AIDS-associated KS lesions with indocyanine green, 2 x 2 mg/kg intravenously, followed immediately by 850 nm light therapy, 100J/cm2.15 Nineteen lesions resolved completely, leaving an atrophic scar, with no recurrences in 2 years.
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