Berson A M, Quivey J M, Harris J W, Wara W M
Department of Radiation Oncology, University of California, San Francisco 94143.
Int J Radiat Oncol Biol Phys. 1990 Sep;19(3):569-75. doi: 10.1016/0360-3016(90)90482-y.
Between March 1982 and October 1987, 375 fields in 187 patients with AIDS-related Kaposi's Sarcoma were treated in the Department of Radiation Oncology at the University of California in San Francisco (UCSF). Field sizes ranging from 2 x 2 cm to total skin received doses of 8 Gy in a single fraction to 15-40 Gy in 5-10 fractions. Seventy-four percent of the patients have died. Response to treatment was achieved in over 90% of treated fields, with a median time to progression of 21 months and an actuarial freedom from relapse at 6 months of 69% (97 patients alive). There was no difference in outcome regardless of the fractionation regimen used. Severe reactions were noted in 17% of treated fields, but this incidence was significantly lower when a single fraction of 8 Gy was used (p less than 0.001). Radiation therapy plays an important palliative role in this devastating disease. This review supports the use of a single 8 Gy fraction for all Kaposi's Sarcoma lesions of the skin. Further data regarding single fraction therapy for lesions of other sites are needed.
1982年3月至1987年10月期间,旧金山加利福尼亚大学(UCSF)放射肿瘤学系对187例艾滋病相关卡波西肉瘤患者的375个病灶进行了治疗。照射野大小从2×2厘米到全皮肤,剂量为单次分割8 Gy至5 - 10次分割的15 - 40 Gy。74%的患者已经死亡。超过90%的治疗病灶有治疗反应,中位进展时间为21个月,6个月时无复发生存率为69%(97例患者存活)。无论采用何种分割方案,结果均无差异。17%的治疗病灶出现严重反应,但当采用单次8 Gy分割时,这一发生率显著降低(p<0.001)。放射治疗在这种毁灭性疾病中发挥着重要的姑息作用。本综述支持对所有皮肤卡波西肉瘤病灶采用单次8 Gy分割。还需要关于其他部位病灶单次分割治疗的进一步数据。