External Beam Radiotherapy Effective for Skin Kaposi Sarcoma Treatment

Kaposi Sarcoma (KS) skin lesions are more likely to respond to local external beam radiotherapy than repeat radiotherapy, according to a study conducted by members of the Department of Radiation Oncology, University of Toronto (ON, Canada), and published in Annals of Palliative Medicine.
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KS is a non-curable malignancy caused by infection with human herpes virus 8 (HHV8). KS lesions are dark colored macules, plaques, or nodules which involve the skin and internal organs. Patients with KS generally have a long recurrent course.

The retrospective study, led by May N Tao, MD, FRCP, Odette Cancer Centre (Toronto, Canada), involved every patient with KS skin lesions treated with radiotherapy at a tertiary cancer center from January 2, 1999 to December 31, 2014. A total of 47 patients were seen, 17 of which had a total of 97 KS skin sites. Those patients were treated with local external beam radiotherapy and an additional 18 KS skin sites were treated with repeat radiotherapy. The most common radiotherapy dose was 8 Gray (Gy) in one fraction or 20 Gy in 5 daily fractions.

Of the KS sites treated with radiation therapy, 87% responded to radiation (30% had a complete response (CR) and 57% had a partial response [PR]). Only 13% of KS sites treated with external beam radiotherapy progressed. There were no CRs among the sites treated with radiotherapy, though half exhibited partial response while the remaining patients progressed.

Results of the study suggest that KS skin lesions are more likely to respond to external beam radiotherapy than to repeat radiotherapy.

The study was limited by the retrospective nature of the analysis, the lack of validated quality of life and symptom control outcomes, and the variation of radiotherapy dose fractionation schedules. Further research is needed, including a study that samples more KS skin sites treated with repeat radiation, to validate local external beam radiotherapy as the best practice.