Intralesional vinblastine for cutaneous Kaposi's sarcoma associated with acquired immunodeficiency syndrome. A clinical trial to evaluate efficacy and discomfort associated with infection.

Abstract

Intralesional vinblastine has been used to treat Kaposi's sarcoma associated with acquired immunodeficiency syndrome (AIDS-KS). Injections are painful and anticipated response rates are not well documented. Eleven homosexual men were studied to evaluate the efficacy and pain associated with intralesional vinblastine with or without 1% bicarbonate buffered lidocaine (BBL). Six lesions on each patient were selected and treated with either vinblastine, vinblastine mixed with BBL, or vinblastine 5 minutes after BBL injection. Control lesions received BBL, saline, or no treatment. Patients recorded injection pain on a visual analog scale. There was a complete or partial clinical response in 88% of vinblastine-treated lesions. Pain scores for BBL, vinblastine, and the mixture of BBL and vinblastine were not statistically different. Intralesional vinblastine is effective therapy for AIDS-KS. Local anesthesia does not reduce efficacy of treatment, or reduce the pain experienced by the patient.