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Radiation Oncology • Sarcoma
How would you suggest to radiate a Kaposi's sarcoma?
Would certain patient/disease characteristics make you choose RT therapy over chemotherapy or other locally ablative therapies? What dose/fraction would you suggest and what margin would you place on the visible lesion? Also, would you differ your approach between a HIV-associated vs classic/endemic Kaposi's sarcoma
Answer from: Radiation Oncologist at Academic Institution
Although you already have some excellent answers, I would like to add a note about Non HIV KS of the feet and hands (so called endemic variety) as sometimes seen in older men of Mediterranean origin. The challenge in this situation is to offer a therapy that produces durable control w/o serious tox...
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Answer from: Radiation Oncologist at Community Practice
Great question. This entity is not seen as often since the intervention of HAART for these epidemic dx'ed folks. In the VA, I still see at least couple of cases per year of both epidemic and classical KS.
I have found regardless of HIV status, for purely cutaneous lesions, 800cGy x 1 is great,...
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Radiation Oncologist at Providence Health, St. Joseph Hospital
I have also found 300 cGy x 10 to be effective.
I have also found 300 cGy x 10 to be effective.
Medical Oncologist at Emory University
Agree with XRT as a last resort. I think of ...
Agree with XRT as a last resort. I think of ...
Answer from: Radiation Oncologist at Community Practice
Hi @Priscila Goncalves. A nice systemic management perspective.However, the things/issues you described I have not seen in a long time, compared to my experience with these cases before the modern era of HIV care. Large plague lesions, which were very prevalent then, often led to the issues you rais...
Answer from: Radiation Oncologist at Academic Institution
A randomized trial at the University of Washington among AIDS patients with Kaposi's sarcoma conducted before the era of HAART showed higher complete response rates and lower risk of local failure with higher doses of radiation than with shorter treatment regiments (8 Gy x 1, 20 Gy in 10 fractions, ...
Answer from: Radiation Oncologist at Community Practice
Hi @Edward Y. Kim. I agree with the data you note concerning protracted course of RT used for epidemic KS lesions pre-HAART era. Indeed a protracted course was often used then. However, as it relates to resource poor countries, where KS lesions are the leading cancers in HIV affected men and women, ...