Radiation therapy in AIDS-related cutaneous Kaposi's sarcoma

Treatment of cutaneous Kaposi's sarcoma associated with AIDS depends on localization, extension, associated symptoms and the patient's general condition. The most frequent sites of involvement are the face and neck. The aim of this retrospective study was to evaluate the response rate as well as the cosmetic results comparing two different schedules of palliative radiation treatment.

251 Skin lesions in 22 patients were treated with irradiation using 100 kV X-ray energy. Applied doses varied between 8 Gy/1 fraction and 30 Gy/10 fractions. The mean age of patients was 38 years (28-59 years). According to Mitsuyasu's staging, 2 patients had stage I, 8 stage II and 12 patients stage IV. The lesions were localized on the face (n = 190), lower extremities (n = 28), upper extremities (n = 24) and the thorax (n = 9). The total given dose was 30 Gy in 68 lesions (27%), 21 Gy in 11 lesions (4.4%), 20 Gy in 2 lesions (0.8%) and 8 Gy in 170 lesions (67.8%).

Complete response with or without residual pigmentation was achieved in 95.2% of lesions, while 4.4% had a partial response and 0.4% no response. Pain was completely relieved in all patients.

Radiotherapy can be recommended as palliative treatment to relieve physical discomfort (pain) and to improve the cosmetic results in patients with AIDS-related Kaposi's sarcoma. Doses ranging from 8 Gy/1 fraction to 30 Gy/10 fractions, tailored to the individual patient's need, permit to achieve an excellent local control with minimal toxicity.