Hypofractionated radiation therapy in the treatment of epidemic Kaposi sarcoma – A prospective randomized trial

Singh, Niveditha; Lakier, R.; Donde, Bernard

doi:10.1016/j.radonc.2008.03.009

Cited by 42 publications

(24 citation statements)

References 22 publications

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“…There is only one prospective trial in the cART era, which reported equal rates of response and cutaneous toxicity for patients treated to 24 Gy in 12 fractions vs. 20 Gy in 5 fractions 17 . Mucosal toxicity was uncommon in both treatment groups (occurring in 2 and 0 individuals, respectively).…”

Section: Radiosensitivity In Patients Treated For Aids-defining Maligmentioning

confidence: 99%

Radiotherapy for patients with the human immunodeficiency virus: Are special precautions necessary?

Housri

Yarchoan

Kaushal

2009

Cancer

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Shortly after the onset of the AIDS epidemic in the 1980s, reports of radiation-associated toxicity in HIV and AIDS patients began to appear in the medical literature. While most reports have focused on AIDS-defining malignancies such as Kaposi's sarcoma, greater than expected toxicity following a course of radiotherapy or chemoradiotherapy has also been documented in cancers not generally classified as HIV-related. With improved antiretroviral therapies, HIV patients are living longer and have the potential to develop a variety of HIV associated and non-associated malignancies that require treatment, including radiation therapy. This review reports the published data on the interactions of HIV, AIDS, and antiretroviral therapy with radiation and the implications for the management of malignancies in HIV patients.

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Section: Radiosensitivity In Patients Treated For Aids-defining Maligmentioning

confidence: 99%

Radiotherapy for patients with the human immunodeficiency virus: Are special precautions necessary?

Housri

Yarchoan

Kaushal

2009

Cancer

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“…The doses recommended in the literature vary from 15 to 30 Gy for HIV-positive patients however are variable for mucosal sites and in HIV-negative patients. 27 Also remarkable, contrary to some toxicity data from the literature showing that toxicity leads to treatment interruption. 28 RT was safe in both HIV-positive and negative patients.…”

Section: Discussionmentioning

confidence: 89%

Mucosal Kaposi sarcoma, a Rare Cancer Network study

et al. 2012

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Kaposi's sarcoma (KS) most often affect the skin but occasionally affect the mucosa of different anatomic sites. The management of mucosal KS is seldom described in the literature. Data from 15 eligible patients with mucosal KS treated between 1994 and 2008 in five institutions within three countries of the Rare Cancer Network group were collected. The inclusion criteria were as follows: age >16 years, confirmed pathological diagnosis, mucosal stages I and II, and a minimum of 6 months' follow-up after treatment. Head and neck sites were the most common (66%). Eleven cases were HIV-positive. CD4 counts correlated with disease stage. Twelve patients had biopsy only while three patients underwent local resection. Radiotherapy (RT) was delivered whatever their CD4 status was. Median total radiation dose was 16.2 Gy (0–45) delivered in median 17 days (0–40) with four patients receiving no RT. Six patients underwent chemotherapy and received from 1 to 11 cycles of various regimens namely vinblastin, caelyx, bleomycine, or interferon, whatever their CD4 counts was. Five-year disease free survival were 81.6% and 75.0% in patients undergoing RT or not, respectively. Median survival was 66.9 months. Radiation-induced toxicity was at worse grade 1–2 and was manageable whatever patients' HIV status. This small series of mucosal KSs revealed that relatively low-dose RT is overall safe and efficient in HIV-positive and negative patients. Since there are distant relapses either in multicentric cutaneous or visceral forms in head and neck cases, the role of systemic treatments may be worth investigations in addition to RT of localized disease. Surgery may be used for symptomatic lesions, with caution given the risk of bleeding.

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“…CKS is generally considered sensitive to radiation therapy with good palliative and esthetic results, demonstrated with doses greater than 20 Gy [9]. In this sense in the literature, a standard dose of treatment is not mentioned; however, radiotherapy hypofractionation has demonstrated to have an impact in terms of recurrence-free survival, toxicity, and local control [10]. For those patients with a limited life expectancy one fraction with 800 cGy has shown to provide successful outcomes [11].…”

Section: Discussionmentioning

confidence: 99%

Classic Kaposi’s sarcoma - complete response to radiation therapy: a case report

Ramírez¹,

Zavala²,

Moran³

et al. 2016

J Med Case Reports

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BackgroundClassic Kaposi’s sarcoma is a lymphatic endothelial cell neoplasm usually present on the skin of the upper and lower extremities. Although it commonly affects human immunodeficiency virus positive patients, there have been some human immunodeficiency virus negative cases reported. We report an uncommon presentation of stage IV classic Kaposi’s sarcoma in an human immunodeficiency virus negative patient in Latin America with complete clinical response using only radiation therapy treatment.Case presentationA 78-year-old Mexican man with no evidence of human immunodeficiency virus infection presented with a painful widespread dermatosis with maculopapular, nodular, violaceous lesions on his legs and ulcerated lesions on his feet. A biopsy confirmed the lesions as classic Kaposi’s sarcoma. Radiotherapy treatment was delivered, prescribing a total dose of 30 Gy in 15 fractions with a complete clinical response within 15 months of follow-up.ConclusionsThis is an unusual case since it is uncommon to use radiation therapy as the single treatment in stage IV classic Kaposi’s sarcoma; the efficacy of the treatment is shown in the impact in our patient’s recurrence-free survival, local control, and palliation of our patient’s symptoms.

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Hypofractionated radiation therapy in the treatment of epidemic Kaposi sarcoma – A prospective randomized trial

Cited by 42 publications

References 22 publications

Radiotherapy for patients with the human immunodeficiency virus: Are special precautions necessary?

Radiotherapy for patients with the human immunodeficiency virus: Are special precautions necessary?

Mucosal Kaposi sarcoma, a Rare Cancer Network study

Classic Kaposi’s sarcoma - complete response to radiation therapy: a case report

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