title: Complete response of endemic Kaposi sarcoma lesions with high-dose-rate brachytherapy: treatment method, results, and toxicity using skin surface applicators.
abstract: OBJECTIVE
  To analyze the clinical outcome of Kaposi sarcoma skin lesions treated with high-dose-rate (HDR) brachytherapy in patients with a minimum of 2 years of followup.
  
  
  METHODS
  Between February 2006 and July 2008, all patients with Kaposi sarcoma who received (192)Ir HDR brachytherapy using a skin surface applicator were evaluated for clinical response. Responses to treatment and toxicity were scored using standard criteria.
  
  
  RESULTS
  Sixteen cases were collected. Treatment was delivered in four to six fractions, over a period of approximately 12 days. The specified dose ranged from 24 to 35Gy. Median followup the lesion was 41.4 months. No lesion was greater than 2cm. All patients had a complete response to treatment, with no evidence of local recurrence or tumor progression. Thirteen lesions developed Grade 1 and two lesions had Grade 2 acute skin reactions. One patient developed late skin changes with telangiectasias and hypopigmentation.
  
  
  CONCLUSIONS
  HDR brachytherapy treatment seems to be an effective noninvasive option for patients with small cutaneous Kaposi sarcoma lesions, delivering excellent cosmesis and local control in our small series. Fewer fractions over a shorter period used in our group offer patients more convenience compared with other common regimens. Although HDR is being used more frequently for many surface applications, additional clinical studies with larger numbers of patients and longer followup are needed to confirm the general impression that it is an excellent option for many patients.
authors: Department of Radiation Oncology, Lynn Cancer Institute, Boca Raton Regional Hospital, Boca Raton, FL. Electronic address: MKasper@brrh.com.
authors: Michael E
authors: ME
authors: Kasper
authors: Sam
authors: S
authors: Richter
authors: Nicholas
authors: N
authors: Warren
authors: Rashmi
authors: R
authors: Benda
authors: Charles
authors: C
authors: Shang
authors: Zoubir
authors: Z
authors: Ouhib
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001918:Brachytherapy / Q000379:methods*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D011882:Radiotherapy, High-Energy; D012189:Retrospective Studies; D012514:Sarcoma, Kaposi / Q000532:radiotherapy*; D012867:Skin / Q000473:pathology / Q000528:radiation effects*; D012878:Skin Neoplasms / Q000532:radiotherapy*
keywords: Brachytherapy; HDR; Kaposi sarcoma; Radiosensitivity; Radiotherapy; Skin cancer; Skin surface applicator