Response and cosmetic outcome of two fractionation regimens for AIDS-related Kaposi's sarcoma.
OBJECTIVE
A prospective study of the response and cosmetic effect of two short duration radiotherapy regimens in the treatment of epidemic cutaneous Kaposi's sarcoma.


METHODS
Between June 1990 and May 1994, 57 patients were recruited into a prospective study of radiotherapy for cutaneous epidemic Kaposi's sarcoma. Patients were offered treatment of either 16 Gy in four fractions over 4 days or 8 Gy as a single fraction. In total 596 lesions were treated in a prospective fashion. Response was assessed in 590 and pigmentation in 573 lesions. A reproducible scale for assessing response and normal cutaneous damage was developed and used to grade the results of treatment.


RESULTS
There was an overall response rate of 78.8% (465/590) for complete responses and pigmented complete responses. Patients receiving 8 Gy as a single fraction had an overall response rate of 77.6% (305/393) and those treated with 16 Gy in four fractions had a response rate of 80.8% (160/198). There was no statistical difference in terms of response between the two groups. There appeared to be a significant variation in response and normal skin pigmentation according to the site irradiated with facial lesions responding best.


CONCLUSIONS
Radiotherapy is a quick and effective treatment for cutaneous epidemic Kaposi's sarcoma. A single fraction of 8 Gy is an appropriate treatment for acceptable response and normal skin pigmentation within a group of patients in whom the median life expectancy is limited.
Harrison
M
M
Department of Oncology, St Mary's Hospital, London, UK.
Harrington
K J
KJ
Tomlinson
D R
DR
Stewart
J S
JS
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D012514:Sarcoma, Kaposi / Q000453:epidemiology / Q000209:etiology / Q000532:radiotherapy*; D012878:Skin Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000532:radiotherapy*; D012880:Skin Pigmentation / Q000528:radiation effects; D015996:Survival Rate; D016896:Treatment Outcome