Chang Ji Hyun, Kim Il Han
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
Radiat Oncol J. 2012 Dec;30(4):153-7. doi: 10.3857/roj.2012.30.4.153. Epub 2012 Dec 31.
There has been no definite consensus on standard treatment, either local or systemic, for the Kaposi's sarcoma (KS). Radiotherapy (RT) can be a good local therapeutic choice especially in non-AIDS associated KS (NAKS) for its indolent behavior.
Medical records of 17 KS patients treated with RT at the Seoul National University Hospital from February 1998 to January 2012 were retrospectively reviewed. One human immunodeficiency virus (HIV)+ patient with 3 lesions was excluded. The total number of the lesion was 23 among the 16 patients. The median follow-up period was 27.9 months. Correlation between response and variables was analyzed using the logistic regression model. Median age of the patients was 75 years. All the 23 lesions were located at the extremities. Fourteen (61%) of those had pain or local swelling as the initial presentation. Ten patients had possible causes of immunodeficiency and were regarded as iatrogenic, and other 6 were classic KS. Median dose of RT was 36 Gy.
No KS-related death was observed. Excluding 2 with short-term follow-up only, complete response and partial response were obtained in 2 (9%) and 19 (73%) lesions, respectively. Of those, 3 lesions underwent local progression. Six had out-of-field recurrence after RT. Symptom improvement was achieved in 13 (93%) of 14 patients. Grade 2 skin toxicities were found in 9 lesions but all got improvement after treatment. When divided into responsive and progressive group, free from progression was not related to any of the possible variables.
RT is effective in local control of NAKS resulting great response rate.
对于卡波西肉瘤(KS)的局部或全身标准治疗,目前尚无明确的共识。放射治疗(RT)因其惰性病程,可能是一种很好的局部治疗选择,尤其是在非艾滋病相关KS(NAKS)中。
回顾性分析1998年2月至2012年1月在首尔国立大学医院接受RT治疗的17例KS患者的病历。排除1例有3处病灶的人类免疫缺陷病毒(HIV)阳性患者。16例患者的病灶总数为23个。中位随访期为27.9个月。使用逻辑回归模型分析反应与变量之间的相关性。患者的中位年龄为75岁。所有23处病灶均位于四肢。其中14处(61%)以疼痛或局部肿胀为首发表现。10例患者有免疫缺陷的可能病因,被认为是医源性的,另外6例为经典KS。RT的中位剂量为36 Gy。
未观察到与KS相关的死亡。排除仅短期随访的2例患者,分别有2处(9%)病灶获得完全缓解,19处(73%)病灶获得部分缓解。其中,3处病灶出现局部进展。6处病灶在RT后出现野外复发。14例患者中有13例(93%)症状得到改善。9处病灶出现2级皮肤毒性,但治疗后均有改善。当分为反应性组和进展性组时,无进展与任何可能的变量均无关。
RT对NAKS的局部控制有效,反应率很高。