RESPONSE AND COSMETIC OUTCOME OF 2 FRACTIONATION REGIMENS FOR AIDS-RELATED KAPOSIS-SARCOMA

Purpose: A prospective study of the response and cosmetic effect of tw o short duration radiotherapy regimens in the treatment of epidemic cu taneous Kaposi's sarcoma. Materials and methods: Between June 1990 and May 1994, 57 patients were recruited into a prospective study of radi otherapy for cutaneous epidemic Kaposi's sarcoma. Patients were offere d treatment of either 16 Cy in four fractions over 4 days or 8 Gy as a single fraction. In total 596 lesions were treated in a prospective f ashion. Response was assessed in 590 and pigmentation in 573 lesions. A reproducible scale for assessing response and normal cutaneous damag e was developed and used to grade the results of treatment. Results: T here was an overall response rate of 78.8% (465/590) for complete resp onses and pigmented complete responses. Patients receiving 8 Gy as a s ingle fraction had an overall response rate of 77.6% (305/393) and tho se treated with 16 Gy in four fractions had a response rate of 80.8% ( 160/198). There was no statistical difference in terms of response bet ween the two groups. There appeared to be a significant variation in r esponse and normal skin pigmentation according to the site irradiated with facial lesions responding best. Conclusions: Radiotherapy is a qu ick and effective treatment for cutaneous epidemic Kaposi's sarcoma. A single fraction of 8 Gy is an appropriate treatment for acceptable re sponse and normal skin pigmentation within a group of patients in whom the median life expectancy is limited. (C) 1997 Elsevier Science Irel and Ltd.