Document 0044
 DOCN  M9650044
 TI    [The value of conventionally fractionated radiotherapy in the local
       treatment of HIV-related Kaposi's sarcoma]
 DT    9605
 AU    Saran F; Adamietz IA; Mose S; Thilmann C; Bottcher HD; Abteilung fur
       Strahlentherapie und Onkologie,; Johann-Wolfgang-Goethe-Universitat,
       Frankfurt am Main.
 SO    Strahlenther Onkol. 1995 Oct;171(10):594-9. Unique Identifier : AIDSLINE
       MED/96163581
 AB    BACKGROUND: During the course of AIDS, 25 to 44% of homosexual patients
       infected with the human immunodeficiency virus develop Kaposi's sarcoma.
       Main manifestation is the skin. Response rates of 80 to 100% can be
       achieved with total dosage up to 50 Gy. Nevertheless, remissions can
       also be attained with 20 Gy of fractionated radiotherapy. As clinical
       data on low dose conventional fractionated radiotherapy are insufficient
       we analysed the response rates of an overall dose of 20 Gy in
       conventional fractionation. PATIENTS AND METHODS: From June 1991 to June
       1993, 43 patients with 111 HIV-associated Kaposi's sarcoma of the skin
       or oral cavity were treated. Lesions were irradiated with 5 to 12 MeV
       electrons or 60Co gamma-rays. The fractionation scheme was 5 times 2
       Gy/week for skin and endoral lesions with a total reference dosage of up
       to 20 Gy. Side effects were assessed during therapy and the therapeutic
       result 6 weeks after end of treatment. RESULTS: Thirty-eight out of 111
       lesions were judged as complete response (CR) (34%), 61/111 as partial
       response (PR) (55%) and 12/111 were judged as no change (NC) (11%).
       Overall response (CR + PR) was 89%. Two patients with lesions of oral
       cavity suffered from RTOG grade-IV mucositis after 10 and 14 Gy. In
       71/106 skin lesions (67%), radiation induced RTOG grade-1 reactions were
       observed. CONCLUSION: In patients with HIV associated Kaposi's sarcoma
       effective palliation can be achieved by means of radiotherapy with an
       overall dose of 20 Gy in conventional fractionation. Yet, the fraction
       of patients with complete responses is with 34 to 47% lower compared
       with doses above 20 Gy (66 to 100%). With reference to the reported data
       our results point to a dose-response relationship for Kaposi's sarcoma.
       Therefore higher total reference doses, e.g. 30 Gy with weekly 5 times 2
       Gy or 24 Gy with 5 times 1.6 Gy for mucous lesions, respectively, are
       suggested as by this mean the complete response rate can be doubled.
 DE    Adult  Antineoplastic Agents, Combined/THERAPEUTIC USE  Combined
       Modality Therapy  English Abstract  Human  HIV Infections/*COMPLICATIONS
       *HIV-1  Male  Middle Age  Mouth Neoplasms/DRUG THERAPY/*RADIOTHERAPY
       Radiotherapy Dosage  Remission Induction  Sarcoma, Kaposi's/DRUG
       THERAPY/*RADIOTHERAPY  Skin Neoplasms/DRUG THERAPY/*RADIOTHERAPY  Time
       Factors  JOURNAL ARTICLE

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