DOI QR코드

DOI QR Code

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

  • Chang, Ji Hyun (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Kim, Il Han (Department of Radiation Oncology, Seoul National University College of Medicine)
  • Received : 2012.09.10
  • Accepted : 2012.10.12
  • Published : 2012.12.30

Abstract

Purpose: There 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 Methods: Medical 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. Results: No 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. Conclusion: RT is effective in local control of NAKS resulting great response rate.

Keywords

References

  1. Antman K, Chang Y. Kaposi's sarcoma. N Engl J Med 2000;342:1027-38. https://doi.org/10.1056/NEJM200004063421407
  2. Regnier-Rosencher E, Guillot B, Dupin N. Treatments for classic Kaposi sarcoma: a systematic review of the literature. J Am Acad Dermatol 2012 Jun 11 [Epub]. http://dx.doi.org/10. 1016/j.jaad.2012.04.018.
  3. Chang Y, Cesarman E, Pessin MS, et al. Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi'ssarcoma. Science 1994;266:1865-9. https://doi.org/10.1126/science.7997879
  4. Goedert JJ, Vitale F, Lauria C, et al. Risk factors for classical Kaposi's sarcoma. J Natl Cancer Inst 2002;94:1712-8. https://doi.org/10.1093/jnci/94.22.1712
  5. Caccialanza M, Marca S, Piccinno R, Eulisse G. Radiotherapy of classic and human immunodeficiency virus-related Kaposi's sarcoma: results in 1482 lesions. J Eur Acad Dermatol Venereol 2008;22:297-302. https://doi.org/10.1111/j.1468-3083.2007.02405.x
  6. Huang KM, Hsu CH, Cheng JC, et al. Radiotherapy of classic Kaposi's sarcoma in Taiwan, an area where classic Kaposi's sarcoma is not prevalent. Anticancer Res 2006;26:4659-63.
  7. Hauerstock D, Gerstein W, Vuong T. Results of radiation therapy for treatment of classic Kaposi sarcoma. J Cutan Med Surg 2009;13:18-21. https://doi.org/10.2310/7750.2008.07076
  8. Choi KH, Byun JH, Lee JY, Cho BK, Park HJ. Kaposi sarcoma after corticosteroid therapy for idiopathic thrombocytopenic purpura. Ann Dermatol 2009;21:297-9. https://doi.org/10.5021/ad.2009.21.3.297
  9. Joo M, Lee SS, Park HJ, Shin HS. Iatrogenic Kaposi's sarcoma following steroid therapy for nonspecific interstitial pneumonia with HHV-8 genotyping. Pathol Res Pract 2006;202:113-7. https://doi.org/10.1016/j.prp.2005.11.005
  10. Cattelan AM, Calabro ML, De Rossi A, et al. Long-term clinical outcome of AIDS-related Kaposi's sarcoma during highly active antiretroviral therapy. Int J Oncol 2005;27:779-85.
  11. Aversa SM, Cattelan AM, Salvagno L, et al. Treatments of AIDSrelated Kaposi's sarcoma. Crit Rev Oncol Hematol 2005;53: 253-65. https://doi.org/10.1016/j.critrevonc.2004.10.009
  12. Fatahzadeh M. Kaposi sarcoma: review and medical management update. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;113:2-16. https://doi.org/10.1016/j.tripleo.2011.05.011
  13. Yildiz F, Genc M, Akyurek S, et al. Radiotherapy in the management of Kaposi's sarcoma: comparison of 8 Gy versus 6 Gy. J Natl Med Assoc 2006;98:1136-9.
  14. Oysul K, Beyzadeoglu M, Surenkok S, Ozyigit G, Dirican B. A dose-response analysis for classical Kaposi's sarcoma management by radiotherapy. Saudi Med J 2008;29:837-40.
  15. Wang X, Wang X, Liang D, Lan K, Guo W, Ren G. Classic Kaposi's sarcoma in Han Chinese and useful tools for differential diagnosis. Oral Oncol 2010;46:654-6. https://doi.org/10.1016/j.oraloncology.2010.06.003
  16. Kanno T, Sato Y, Nakamura T, Sakamoto K, Sata T, Katano H. Genotypic and clinicopathological characterization of Kaposi's sarcoma-associated herpesvirus infection in Japan. J Med Virol 2010;82:400-6. https://doi.org/10.1002/jmv.21715
  17. Dilnur P, Katano H, Wang ZH, et al. Classic type of Kaposi's sarcoma and human herpesvirus 8 infection in Xinjiang, China. Pathol Int 2001;51:845-52. https://doi.org/10.1046/j.1440-1827.2001.01293.x

Cited by

  1. Dosimetric comparison of 4 MeV and 6 MeV electron beams for total skin irradiation vol.9, pp.None, 2014, https://doi.org/10.1186/1748-717x-9-197
  2. A Series of Patients with Kaposi Sarcoma (Mediterranean/Classical Type): Case Presentations and Short Update on Pathogenesis and Treatment vol.6, pp.9, 2012, https://doi.org/10.3889/oamjms.2018.354
  3. Clinical features of Kaposi's sarcoma: experience from a Taiwanese medical center vol.58, pp.12, 2012, https://doi.org/10.1111/ijd.14476