RADIATION THERAPY FOR KAPOSI'S SARCOMA IN AIDS

Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

RADIATION THERAPY FOR KAPOSI'S SARCOMA IN AIDS

Kaposi's Sarcoma: Pathophysiology and Clinical Management. Ziegler JL, Dorfman RF, eds. New York, Marcel Dekker, p. 237-48, 1988.. Unique Identifier : AIDSLINE ICDB/89650417
Harris JW; Berson AM; Reed TA; Wara WM; Dept. of Radiation Oncology, Sch. of Medicine, Univ. of; California, San Francisco, CA

Abstract: Published data and the authors' clinical experience are presented in a discussion of radiation therapy in patients (pts) with AIDS-associated Kaposi's sarcoma (KS). Topics include radiation therapy in nonepidemic KS; radiation therapy in epidemic KS, including specific treatment recommendations by site (cutaneous lesions, mucosal lesions, lymph nodes, eye and eyelid, and lung); and practical aspects of treatment (procedures, coordination and in-service training). In view of the efficacy of radiation therapy in nonepidemic KS, it was anticipated that the epidemic form of this tumor would be radiosensitive. Epidemic KS did respond well to radiation, but some unexpected results were encountered, including unusually severe side effects at certain sites and a significant rate of relapse among 'successfully treated' pts. As a result of this experience, original treatment strategies were modified. The authors currently treat cutaneous lesions with one of three daily fractionation schemes: 200 cGy per fraction to a total dose of 2000-3000 cGy, 400 cGy per fraction to a total of 2000-2400 cGy, or 800 cGy in a single fraction. For oral mucosal lesions, daily fractions as low as 150 cGy to a total of 1500-2000 cGy are recommended. Of pts treated by the authors for nodal disease in noninguinal sites, 82% have had durable responses with 800 cGy in one fraction or 2000 cGy in ten fractions. In contrast, only 61% of pts with inguinal node involvement responded to treatment. Undetected pelvic node involvement may account for the poor results in this latter group. With respect to lesions of the eye and eyelid, the authors suggest doses of approx 3000 cGy using conventional fractionation. For pts with KS of the lung, the total dose to both lungs should be limited to 1500 cGy in 150-cGy fractions, and prophylactic antibiotic therapy for P carinii pneumonia should be considered. (16 Refs)

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/EPIDEMIOLOGY Disease Outbreaks Human Lymphatic Metastasis Radiotherapy Dosage Sarcoma, Kaposi's/EPIDEMIOLOGY/*RADIOTHERAPY Skin Neoplasms/EPIDEMIOLOGY/*RADIOTHERAPY MONOGRAPH REVIEW, TUTORIAL REVIEW

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