Radiotherapy in the Management of Localized Classic Kaposi's Sarcoma

Purpose: Classic Kaposi's sarcoma (CKS) is a prevalent indolent neoplasm among Eastern European and Mediterranean origin, but is rare in the other ethnic groups.Radiotherapy may provide symptom relief and tumor control in patients who have a few lesions in a limited area. This study was to assess the effectiveness of radiotherapy in the local control and the symptom relief of the CKS.Materials and Methods: Between August 1994 and November 2004, 48 patients with histologically proven Kaposi's sarcoma were selected for review from the Cancer Registry of National Taiwan University Hospital, eleven patients were both human immunodeficiency virus (HIV)-negative and non organ-transplant recipients. These patients received radiotherapy and were eligible for this study. Treatment methods consisted of local radiotherapy using Cobalt-60 teletherapy, megavoltage photon beam or electron beam. The treatment fields, fractionation, and total dose of radiation were determined on the clinical basis.
Results: A total of 11 patients (20 lesions) were enrolled into this study. There were 9 men and 2 women, with a mean age of 66 years. Median follow-up for surviving patients ranged from 4 to 44 months (median, 17 months). Target dose ranged from 30 Gy in ten fractions to 40 Gy in twenty fractions, with the exceptions in four lesions (2 patients). The complete response rate was 75% (15 lesions), and the partial response was evident in the remaining lesions. Median free from recurrence interval has not been reached. The 3-month, 6-month and 1.5-year local regional control rates were 95%, 74% and 74%, respectively. Symptom relief was achieved in all patients. Chronic complications including exudative dermatitis and variable degrees of edema were rare and mild.Conclusion: With the few late complication of mild edema and hyperpigmentation, local radiotherapy to CKS was well tolerated and effective. These data suggest that the local radiotherapy remains the effective treatment modality for non-HIV related localized classic Kaposi's sarcoma.