Abstract
OBJECTIVE: To evaluate prospectively the efficacy of a single fraction of high-dose radiotherapy in patients with Kaposi's sarcoma. PATIENTS: Between 1994 and 2004, 47 patients with Kaposi's sarcoma were treated at Hacettepe University, Department of Radiation Oncology. Thirteen (28%) patients received chemotherapy before radiotherapy and were referred due to recurrent or progressive disease or intolerance to chemotherapy. All lesions were treated locally with a 2-3-cm safety margin with 4-6-MeV electron beams. Radiotherapy consisted of a single fraction of 8 Gy in the first four years and 6 Gy thereafter. RESULTS: The male:female ratio was 4:1. The median age was 61 years (range 18-87). Eight out of 47 patients (17%) had an underlying immunocompromised state, and one had a previous diagnosis of Hodgkin's disease. Of 203 fields treated, 51 and 152 fields were treated with 8 Gy and 6 Gy, respectively. Overall response rates (RR) at 12 months for 8- and 6 Gy were 93% and 86%, which were not statistically different. However, the difference between complete RRs at 12 months (93% and 60% for 8 Gy and 6 Gy respectively) was significant (p<0.0001). Progression-free survival and reirradiation rates were not significantly different. Side effects were tolerable in all but three patients with grade 2-3 fibrosis and edema. CONCLUSION: Radiotherapy is an effective mode of treatment for Kaposi's sarcoma, and a single dose of 8 Gy is more effective in terms of complete RR compared to 6 Gy, though overall response and progression-free survival rates were similar.
Full text
PDF



Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Antman K., Chang Y. Kaposi's sarcoma. N Engl J Med. 2000 Apr 6;342(14):1027–1038. doi: 10.1056/NEJM200004063421407. [DOI] [PubMed] [Google Scholar]
- Berson A. M., Quivey J. M., Harris J. W., Wara W. M. Radiation therapy for AIDS-related Kaposi's Sarcoma. Int J Radiat Oncol Biol Phys. 1990 Sep;19(3):569–575. doi: 10.1016/0360-3016(90)90482-y. [DOI] [PubMed] [Google Scholar]
- Brambilla L., Labianca R., Ferrucci S. M., Taglioni M., Boneschi V. Treatment of classical Kaposi's sarcoma with gemcitabine. Dermatology. 2001;202(2):119–122. doi: 10.1159/000051610. [DOI] [PubMed] [Google Scholar]
- Brenner B., Rakowsky E., Katz A., Gutman H., Sulkes A., Schacter J., Fenig E. Tailoring treatment for classical Kaposi's sarcoma: comprehensive clinical guidelines. Int J Oncol. 1999 Jun;14(6):1097–1102. doi: 10.3892/ijo.14.6.1097. [DOI] [PubMed] [Google Scholar]
- Chang L. F., Reddy S., Shidnia H. Comparison of radiation therapy of classic and epidemic Kaposi's sarcoma. Am J Clin Oncol. 1992 Jun;15(3):200–206. doi: 10.1097/00000421-199206000-00004. [DOI] [PubMed] [Google Scholar]
- Cooper J. S., Steinfeld A. D., Lerch I. Intentions and outcomes in the radiotherapeutic management of epidemic Kaposi's sarcoma. Int J Radiat Oncol Biol Phys. 1991 Mar;20(3):419–422. doi: 10.1016/0360-3016(91)90051-5. [DOI] [PubMed] [Google Scholar]
- Finesmith T. H., Shrum J. P. Kaposi's sarcoma. Int J Dermatol. 1994 Nov;33(11):755–762. doi: 10.1111/j.1365-4362.1994.tb00983.x. [DOI] [PubMed] [Google Scholar]
- Friedman-Birnbaum R., Weltfriend S., Katz I. Kaposi's sarcoma: retrospective study of 67 cases with the classical form. Dermatologica. 1990;180(1):13–17. doi: 10.1159/000247978. [DOI] [PubMed] [Google Scholar]
- Friedman-Kien A. E., Saltzman B. R. Clinical manifestations of classical, endemic African, and epidemic AIDS-associated Kaposi's sarcoma. J Am Acad Dermatol. 1990 Jun;22(6 Pt 2):1237–1250. doi: 10.1016/0190-9622(90)70169-i. [DOI] [PubMed] [Google Scholar]
- Hamilton C. R., Cummings B. J., Harwood A. R. Radiotherapy of Kaposi's sarcoma. Int J Radiat Oncol Biol Phys. 1986 Nov;12(11):1931–1935. doi: 10.1016/0360-3016(86)90127-6. [DOI] [PubMed] [Google Scholar]
- Harrison M., Harrington K. J., Tomlinson D. R., Stewart J. S. Response and cosmetic outcome of two fractionation regimens for AIDS-related Kaposi's sarcoma. Radiother Oncol. 1998 Jan;46(1):23–28. doi: 10.1016/s0167-8140(97)00141-2. [DOI] [PubMed] [Google Scholar]
- Hill D. R. The role of radiotherapy for epidemic Kaposi's sarcoma. Semin Oncol. 1987 Jun;14(2 Suppl 3):19–22. [PubMed] [Google Scholar]
- Holecek M. J., Harwood A. R. Radiotherapy of Kaposi's sarcoma. Cancer. 1978 May;41(5):1733–1738. doi: 10.1002/1097-0142(197805)41:5<1733::aid-cncr2820410513>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
- Kigula-Mugambe Joseph B., Kavuma Awusi. Epidemic and endemic Kaposi's sarcoma: a comparison of outcomes and survival after radiotherapy. Radiother Oncol. 2005 Jul;76(1):59–62. doi: 10.1016/j.radonc.2005.06.008. [DOI] [PubMed] [Google Scholar]
- Lo T. C., Salzman F. A., Smedal M. I., Wright K. A. Radiotherapy for Kaposi's sarcoma. Cancer. 1980 Feb 15;45(4):684–687. doi: 10.1002/1097-0142(19800215)45:4<684::aid-cncr2820450411>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
- Nisce L. Z., Safai B., Poussin-Rosillo H. Once weekly total and subtotal skin electron beam therapy for Kaposi's sarcoma. Cancer. 1981 Feb 15;47(4):640–644. doi: 10.1002/1097-0142(19810215)47:4<640::aid-cncr2820470403>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
- Olweny Charles L. M., Borok Margaret, Gudza Ivy, Clinch Jennifer, Cheang Mary, Kiire Clem F., Levy Lorraine, Otim-Oyet David, Nyamasve Joseph, Schipper Harvey. Treatment of AIDS-associated Kaposi's sarcoma in Zimbabwe: results of a randomized quality of life focused clinical trial. Int J Cancer. 2005 Feb 10;113(4):632–639. doi: 10.1002/ijc.20606. [DOI] [PubMed] [Google Scholar]
- Piccinno R., Caccialanza M., Cusini M. Role of radiotherapy in the treatment of epidemic Kaposi's sarcoma: experience with sixty-five cases. J Am Acad Dermatol. 1995 Jun;32(6):1000–1003. doi: 10.1016/0190-9622(95)91339-4. [DOI] [PubMed] [Google Scholar]
- Piedbois P., Frikha H., Martin L., Levy E., Haddad E., Le Bourgeois J. P. Radiotherapy in the management of epidemic Kaposi's sarcoma. Int J Radiat Oncol Biol Phys. 1994 Dec 1;30(5):1207–1211. doi: 10.1016/0360-3016(94)90330-1. [DOI] [PubMed] [Google Scholar]
- Sarid R., Wiezorek J. S., Moore P. S., Chang Y. Characterization and cell cycle regulation of the major Kaposi's sarcoma-associated herpesvirus (human herpesvirus 8) latent genes and their promoter. J Virol. 1999 Feb;73(2):1438–1446. doi: 10.1128/jvi.73.2.1438-1446.1999. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stein M. E., Kantor A., Spencer D., Bezwoda W. R. Classical Kaposi's sarcoma in Caucasians in Africa--experience at the Johannesburg Hospital (1978-1992). Dermatology. 1994;188(3):182–187. doi: 10.1159/000247135. [DOI] [PubMed] [Google Scholar]
- Stelzer K. J., Griffin T. W. A randomized prospective trial of radiation therapy for AIDS-associated Kaposi's sarcoma. Int J Radiat Oncol Biol Phys. 1993 Dec 1;27(5):1057–1061. doi: 10.1016/0360-3016(93)90523-x. [DOI] [PubMed] [Google Scholar]
- Tombolini V., Osti M. F., Bonanni A., Valeriani M., Iacari W., Donato V., Enrici R. M. Radiotherapy in classic Kaposi's sarcoma (CKS): experience of the Institute of Radiology of University "La Sapienza" of Rome. Anticancer Res. 1999 Sep-Oct;19(5C):4539–4544. [PubMed] [Google Scholar]
- Wahman A., Melnick S. L., Rhame F. S., Potter J. D. The epidemiology of classic, African, and immunosuppressed Kaposi's sarcoma. Epidemiol Rev. 1991;13:178–199. doi: 10.1093/oxfordjournals.epirev.a036068. [DOI] [PubMed] [Google Scholar]
- Weshler Z., Loewinger E., Loewenthal E., Levinson R., Fuks Z. Megavoltage radiotherapy using water bolus in the treatment of Kaposi's sarcoma. Int J Radiat Oncol Biol Phys. 1986 Nov;12(11):2029–2032. doi: 10.1016/0360-3016(86)90142-2. [DOI] [PubMed] [Google Scholar]
- Yildiz F., Ozyar E., Uzal D., Sahin S., Atahan I. L. Kaposi's sarcoma: the efficacy of a single fraction of 800 cGy. Dermatology. 1997;195(2):142–144. doi: 10.1159/000245717. [DOI] [PubMed] [Google Scholar]
