Variants of Kaposi's sarcoma in Southern Africa. A retrospective analysis (1980-1992).
Stein ME, Lachter J, Spencer D, Margolius L, Bezwoda WR.
Northern Israel Oncology Center, Haifa, Israel.
All types of Kaposi's sarcoma (KS) are represented in the Southern African region. We present a retrospective analysis of patients with KS, treated and followed up at the Johannesburg General Hospital over a 12-year period (1980-1992). One hundred and nineteen patients with KS, divided into four groups according to their etiology (classical; endemic African; renal transplant recipients; epidemic AIDS-related) were analyzed. Choice of treatment (radiotherapy or chemotherapy) was individualized and based on clinical criteria, extent of disease and severity of symptoms. Kaposi's sarcoma showed a very high response rate to radiation therapy, regardless of variant, radiation modality or schedule. Chemotherapy was also effective in the more aggressive pattern of endemic African KS. Epidemic Kaposi's sarcoma showed the same poor outcome as demonstrated by its Western counterpart. We conclude that radiation therapy can provide excellent palliation with only minimal side-effects in all variants of KS seen in Southern Africa.
PIP: During 1980-92, in South Africa, the Department of Medical Oncology and Clinical Hematology of Johannesburg General Hospital received 119 patients aged 23-82 with histologically confirmed Kaposi's sarcoma (KS). Researchers divided them into four groups based on their etiology: classical KS, endemic African KS, renal transplant recipients, and epidemic AIDS-related KS. The oncologists determined the treatment for each individual based on clinical criteria, extent of disease, and severity of symptoms. Regardless of type of KS, radiation modality, or schedule, KS responded very well to radiation therapy (e.g., partial or complete remission: 86% for endemic African KS, 90% for AIDS-related KS [partial remission only]). Radiation therapy was more likely to provide symptomatic relief for AIDS-related KS patients than chemotherapy (80% vs. 9%). Among AIDS-related KS patients, all nonresponders died rapidly from progressive disease and/or from exacerbating opportunistic infections. Chemotherapy also effectively treated endemic African KS (partial or complete remission: 81% vs. 38% for AIDS-related KS). Side effects were minimal in KS patients being treated with radiation. In conclusion, radiation therapy provides excellent results with few side effects in all types of KS in South Africa.
PMID: 8639315 [PubMed - indexed for MEDLINE]