Palliation of AIDS-related Kaposi's sarcoma of the head and neck mucosa using radiotherapy with altered fractionation to avoid local toxicity (Meeting abstract).

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Palliation of AIDS-related Kaposi's sarcoma of the head and neck mucosa using radiotherapy with altered fractionation to avoid local toxicity (Meeting abstract).

Proc Annu Meet Am Soc Clin Oncol; 16:A159 1997. Unique Identifier : AIDSLINE MED/97622150
Jagetia R; Kiel KD; Von Roenn J; Dutta S; Northwestern Memorial Hospital and Northwestern University Medical; School, Chicago, IL

Abstract: AIDS related Kaposi's Sarcoma (KS) frequently involves the oral cavity and can cause pain, difficulty swallowing, altered speech, and obstruction. Radiotherapy (generally 20 Gy in 2 Gy fractions daily) reduces tumor bulk but is frequently associated with severe mucositis, more than observed in non-AIDS patients. We evaluated the efficacy and toxicity of an altered fractionation scheme to palliate KS lesions of the oral cavity in 18 pts with KS of the oral cavity and hypopharynx. 2 Gy every other day (M, W, F) was delivered to a median dose of 20 Gy (range: 18-30 Gy) with parallel opposed fields averaging 47 cm2, except for 1 pt treated with a single lateral field. Presenting symptoms included pain (15/18), difficulty swallowing (3/18), bleeding (1/18), and mass effect (1/18). Two pts were referred after failing intralesional chemotherapy. Median CD4 count was 30. All pts were prophylaxed with sucralfate and anti-fungal medications. All 18 pts responded with flattening of KS lesions and improvement in symptoms. There were 4 recurrences and 2 new lesions in the radiation fields. Three pts were retreated with the same fractionation scheme and responded. 14 Gy did not palliate a new lesion in one pt. 15/18 pts developed signs of mild mucositis or xerostomia that did not interfere with oral intake, but none had localized symptoms severe enough to interrupt or terminate treatment. In conclusion, this altered fractionation scheme is well tolerated, successfully palliates Kaposi's Sarcoma of the head and neck mucosa, and should be considered for use in the management of symptomatic KS to avoid local toxicity. (C) American Society of Clinical Oncology 1997

Keywords: *AIDS-Related Opportunistic Infections/RADIOTHERAPY *Head and Neck Neoplasms/RADIOTHERAPY *Palliative Care *Sarcoma, Kaposi/RADIOTHERAPY
971230
M97C1596

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