Response to radiotherapy of head and neck tumors in AIDS patients

Initial manifestations of AIDS in the head and neck area occur frequently. In fact, up to 40 percent of patients may have involvement of the head and neck. The most common malignancies are Kaposi's sarcoma and non-Hodgkin's lymphoma. Since AIDS-related malignancies are a relatively new problem for radiation oncologists, optimal therapy for these neoplasms is unknown. A retrospective review of AIDS patients treated with radiotherapy has been performed. Fourteen patients were identified. Of these, five were treated for head and neck tumors (four for Kaposi's sarcoma and one for non-Hodgkin's lymphoma). Epidemic Kaposi's sarcoma, as well as non-Hodgkin's lymphoma, were seen to be as radioresponsive as the classical forms, but local control was difficult to achieve. Kaposi's sarcoma tended to recur marginally and within the field. Nonetheless, we believe radiotherapy can offer significant palliation for AIDS patients with head and neck tumors. It is of utmost importance that the head and neck surgeon must be acutely aware of the common patterns of presentation of this disease.