Le Bourgeois J P, Geara F, Piedbois P, Haddad E, Lévy E, Taghian A, Sagna C
Département de cancérologie, Hôpital Henri-Mondor, Créteil.
Ann Dermatol Venereol. 1990;117(1):17-21.
Between June 1986 and December 1988, 149 patients with AIDS-related Kaposi's sarcoma were treated by cutaneous irradiation in our department. According to Mitsuyasu's staging, 34 patients (23 p. 100) were stage I, 82 (55 p. 100) stage II and 33 (22 p. 100) stage IV; no stage III was reported. Fifty eight patients (39 p. 100) had previously presented with one or several opportunistic infections. Ninety four patients (63 p. 100) had previously received treatment with interferon in 85 (57 p. 100) and/or Velbe in 43 (29 p. 100). 319 cutaneous localisations were treated, 59 p. 100 by extended cutaneous irradiation, using 4 and/or 8 MeV electron beam energy, and 41 p. 100 by localized irradiation, using 45 kVX-ray energy, 2.5 Gy/fraction, 4 times a week by split course 20 Gy then 10 Gy two weeks later. Twenty patients (13 p. 100) with oedema of the lower limbs were treated, using 4 MV photon therapy with bolus, and 3 (2 p. 100) were treated for lesions in the ENT regions. Only 131 patients were evaluable (257 localisations); 62 p. 100 obtained complete remission and 31 p. 100 partial remission after a mean period of 1.5 months (0.5-3 months). The overall tolerance was acceptable. The complications were epidermitis with some necrosis (8 p. 100), exudative epidermitis (26 p. 100), moderate epidermitis (63 p. 100) and slight reactions in 4 p. 100. The mean recurrence time was 5 1/2 months.
1986年6月至1988年12月期间，我科对149例艾滋病相关的卡波西肉瘤患者进行了皮肤照射治疗。根据光安的分期，34例（占23%）为I期，82例（占55%）为II期，33例（占22%）为IV期；未报告III期病例。58例（占39%）患者先前曾出现过一种或几种机会性感染。94例（占63%）患者先前曾接受过干扰素治疗，其中85例（占57%）使用过干扰素，43例（占29%）使用过威伯（Velbe）。共治疗了319处皮肤病变，其中59%采用扩大皮肤照射，使用4和/或8兆电子伏电子束能量；41%采用局部照射，使用45千伏X射线能量，每次2.5戈瑞，每周4次，分疗程照射，先照射20戈瑞，两周后再照射10戈瑞。20例（占13%）下肢水肿患者采用4兆伏光子治疗并加用组织等效物，3例（占2%）患者因耳鼻喉区域病变接受治疗。只有131例患者可评估（257处病变）；平均1.5个月（0.5 - 3个月）后，62%获得完全缓解，31%获得部分缓解。总体耐受性尚可。并发症包括伴有一些坏死的表皮炎（占8%）、渗出性表皮炎（占26%）、中度表皮炎（占63%）以及4%的轻微反应。平均复发时间为5个半月。
