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Response and cosmetic outcome of two fractionation regimens for AIDS-related Kaposi's sarcoma
M Harrison1, K J Harrington, D R Tomlinson
1Department of Oncology, St Mary's Hospital, London, UK.
Purpose:
A prospective study of the response and cosmetic effect of two short duration radiotherapy regimens in the treatment of epidemic cutaneous Kaposi's sarcoma.
Materials And 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.