Results of Radiation Therapy for Treatment of Classic Kaposi Sarcoma

Hauerstock, David; Gerstein, William; Vuong, T.

doi:10.2310/7750.2008.07076

Cited by 30 publications

(20 citation statements)

References 15 publications

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“…28 RT was safe in both HIV-positive and negative patients. This is consistent with a recent report by Hauerstock et al 29 In our series, two patients had cutaneous relapse following first mucosal presentation and one had lung metastases. Whether cutaneous presentation represents multicentric or metastatic disease is not known.…”

Section: Discussionsupporting

confidence: 94%

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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Section: Discussionsupporting

confidence: 94%

Mucosal Kaposi sarcoma, a Rare Cancer Network study

et al. 2012

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“…In the local control of KS, RT plays an important role. A number of reports showed excellent response rates up to 98.7% after 13.5 years of follow-up [5-7]. …”

Section: Introductionmentioning

confidence: 99%

Role of radiotherapy in local control of non-AIDS associated Kaposi's sarcoma patients in Korea: a single institution experience

Chang

Kim

2012

Radiat Oncol J

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PurposeThere has been no definite consensus on standard treatment, either local or systemic, for the Kaposi's sarcoma (KS). Radiotherapy (RT) can be a good local therapeutic choice especially in non-AIDS associated KS (NAKS) for its indolent behavior.Materials and MethodsMedical records of 17 KS patients treated with RT at the Seoul National University Hospital from February 1998 to January 2012 were retrospectively reviewed. One human immunodeficiency virus (HIV)+ patient with 3 lesions was excluded. The total number of the lesion was 23 among the 16 patients. The median follow-up period was 27.9 months. Correlation between response and variables was analyzed using the logistic regression model. Median age of the patients was 75 years. All the 23 lesions were located at the extremities. Fourteen (61%) of those had pain or local swelling as the initial presentation. Ten patients had possible causes of immunodeficiency and were regarded as iatrogenic, and other 6 were classic KS. Median dose of RT was 36 Gy.ResultsNo KS-related death was observed. Excluding 2 with short-term follow-up only, complete response and partial response were obtained in 2 (9%) and 19 (73%) lesions, respectively. Of those, 3 lesions underwent local progression. Six had out-of-field recurrence after RT. Symptom improvement was achieved in 13 (93%) of 14 patients. Grade 2 skin toxicities were found in 9 lesions but all got improvement after treatment. When divided into responsive and progressive group, free from progression was not related to any of the possible variables.ConclusionRT is effective in local control of NAKS resulting great response rate.

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“…Treatment for KS changed over the past 30 years and patients diagnosed and treated in the 2000s were treated much differently than those in the 1980s and 1990s. Currently, treatment options for localized cutaneous KS lesions include surgery [47], radiation [48, 49], cryotherapy/laser therapy [50–52], intralesional injection of chemotherapy (vinblastine; [53, 54]), topical therapy ( cis -retinoic acid [55]), and (imiquimod [56]). Highly active antiretroviral treatment (HAART) is recommended for all patients with AIDS-related KS [57–59], despite the finding that its initiation is associated with temporary progression of KS lesions within the first three to six weeks, corresponding with the well-described immune reconstitution syndrome [60, 61].…”

Section: Discussionmentioning

confidence: 99%

Trends in Kaposi’s Sarcoma in Miami Beach from 1987 to 2007

et al. 2012

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Purpose. Kaposi's sarcoma (KS) is a rare low-grade vascular tumor associated with the human herpes virus 8. By analyzing the epidemiology, staging, and treatment of KS, we hoped to improve the quality of care at our institution. Methods. Review of the Mount Sinai Medical Center tumor registry database in Miami Beach, FL, USA, identified 143 cases of KS between January 1, 1987 and December 31, 2007. Results. The majority of patients were non-Hispanic whites, non smoking males diagnosed between 1987 and 1996. Most of the patients were HIV positive, with an equal percentage diagnosed with local or distant disease. Most patients received no chemotherapy or radiation. There were no significant differences in patient survival based on sex, HIV status, or radiation received. There was a trend toward improved survival among older patients who smoked, received no chemotherapy, and had localized stage at diagnosis. Multivariate analysis revealed that non-Hispanic whites had a significant worse survival than Hispanic whites (HR = 0.55, 95% CI (0.33, 0.90), P = 0.02). Patients diagnosed between 1987 and 1996 had a worse survival than those between 1997 and 2007 (HR = 0.33 (95% CI 0.19, 0.55), P < 0.0001). Conclusion. This large retrospective study provides further insight into KS. Ethnicity and date of diagnosis are important predictors of long-term survival.

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Results of Radiation Therapy for Treatment of Classic Kaposi Sarcoma

Abstract: Radiation therapy is an effective treatment modality for CKS and is associated with minimal toxicity.

Cited by 30 publications

References 15 publications

Mucosal Kaposi sarcoma, a Rare Cancer Network study

Mucosal Kaposi sarcoma, a Rare Cancer Network study

Role of radiotherapy in local control of non-AIDS associated Kaposi's sarcoma patients in Korea: a single institution experience

Trends in Kaposi’s Sarcoma in Miami Beach from 1987 to 2007

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