Radiotherapy in the management of Kaposi's sarcoma: comparison of 8 Gy versus 6 Gy.
OBJECTIVE
To evaluate prospectively the efficacy of a single fraction of high-dose radiotherapy in patients with Kaposi's sarcoma.


METHODS
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.


CONCLUSIONS
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.
Yildiz
Ferah
F
Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. fyildiz@hacettepe.edu.tr
Genc
Mine
M
Akyurek
Serap
S
Cengiz
Mustafa
M
Ozyar
Enis
E
Selek
Ugur
U
Atahan
I Lale
IL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006689:Hodgkin Disease / Q000276:immunology*; D006784:Hospitals, Teaching; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D012514:Sarcoma, Kaposi / Q000178:diet therapy / Q000532:radiotherapy*; D016896:Treatment Outcome; D014421:Turkey