Efficacy of immunotherapy with combination of cryotherapy and topical imiquimod for treatment of Kaposi sarcoma.
Efficacy of immunotherapy with combination of cryotherapy and topical imiquimod for treatment of Kaposi sarcoma.
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冷冻疗法和局部咪喹莫特联合免疫疗法治疗卡波西肉瘤的疗效。
DOI：
10.1002/jmv.28396
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发表时间：
2023
影响因子：
12.7
通讯作者：
Deng,Liang
中科院分区：
文献类型：
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作者：
Gu,Lilly;Lin,Erica;Liu,Shuaitong;Yang,Ning;Kurtansky,Nicholas;Neumann,NeilM;Stoll,Joseph;Lezcano,Cecilia;Pulitzer,Melissa;Noor,Sarah;Markova,Alina;Rossi,Anthony;Dickson,MarkA;Deng,Liang
卡波西肉瘤（KS）的多种治疗方式已有报道，包括化疗、放疗、手术切除、电疗和冷冻治疗。常见的局部治疗方法包括替马洛尔、咪喹莫特和阿利维甲酸。我们在机构数据库中检索了2004年7月1日至2022年1月1日期间由具有KS管理经验的皮肤科医生所见的具有ICD‐9或10编码的KS患者。我们筛选了患者图表，包括接受冷冻联合治疗后每周三次局部咪喹莫特，持续2个月的患者（n= 9）。每3个月随访一次。通过皮肤科医生确定的分辨率的照片证据并与患者图表中的临床文件相证实来评估解决时间。KS诊断时的中位年龄（IQR）为58岁（27.5岁）。所有患者均为男性（n= 9, 100%）。大多数是白人（n= 7,78%）和非西班牙裔（n= 8,89%）。5人（56%）患有典型KS， 1人（11%）患有HIV相关KS， 3人（33%）是HIV阴性的男男性行为者。中位缓解时间为30.5周，中位为两次治疗。在我们的研究中，93% （n= 42/45）的病变和89% （n= 8/9）的患者在58（13-209）周的中位（范围）随访期间完全消退。副作用仅限于冷冻治疗期间的疼痛，冷冻治疗后偶尔形成水疱，以及咪喹莫特引起的轻度炎症。未见感染。冷冻疗法和局部咪喹莫特联合治疗可能是一种有效且相对低风险的治疗有限皮肤性KS的方法。
Multiple treatment modalities for Kaposi sarcoma (KS) have been reported, including chemotherapy, radiation therapy, surgical excision, electrochemotherapy, and cryotherapy. Common topical treatments include timolol, imiquimod, and alitretinoin. We searched our institutional database for patients with ICD‐9 or 10 codes for KS seen by a dermatologist with experience in KS management from July 1, 2004 to January 1, 2022. We screened patient charts to include patients who received combination therapy of cryotherapy followed by topical imiquimod three times a week for 2 months (n= 9). Patients were followed in the clinic every 3 months. Time to resolution was assessed by photographic evidence of resolution as determined by a dermatologist and corroborated with clinical documentation in patient charts. Median age (IQR) at KS diagnosis was 58 (27.5) years. All patients were male (n= 9, 100%). Majority were white (n= 7, 78%) and non‐Hispanic (n= 8, 89%). Five (56%) had classic KS, one (11%) had HIV‐associated KS, and three (33%) were HIV‐negative men who have sex with men. Median time to resolution was 30.5 weeks, with a median of two treatments. In our study, 93% (n= 42/45) of lesions and 89% (n= 8/9) of patients experienced complete resolution during a median (range) duration of follow‐up of 58 (13–209) weeks. Side effects were limited to pain during cryotherapy, occasional blister formation after cryotherapy, and mild inflammation due to imiquimod. No infections were observed. Combination therapy of cryotherapy and topical imiquimod may be an efficacious and comparatively low‐risk treatment for limited, cutaneous KS.