Radiation Oncology/Kaposi's sarcoma/Randomized

Randomized Evidence for Kaposi's Sarcoma

• Johannesburg Hospital (South Africa)(2003-2004) -- RT 24/12 vs. 20/5
  • Randomized. 65 sites of epidemic Kaposi sarcoma (histolocially proven, HIV+, mucosal or cutaneous). Arm 1) RT 24/12 vs. Arm 2) RT 20/5. Tumor + 2cm margin, if oral location then entire oral cavity
  • 2008 PMID 18439694 -- "Hypofractionated radiation therapy in the treatment of epidemic Kaposi sarcoma - A prospective randomized trial." (Singh NB, Radiother Oncol. 2008 Apr 23 [Epub ahead of print])
    • Outcome: CR 24/12 37% vs. 20/5 50% (NS), local control (CR/PR/SD) 66% vs. 90% (NS). Mean time-to-response 3 months
    • Toxicity: No difference, but necrosis/ulceration in 3% vs. 17%
    • Conclusion: The two schedules produced equivalent results

• University of Washington -- RT 8/1 vs. 20/10 vs. 40/20
  • Randomized, 3 arms. 71 cutaneous lesions. Arm 1) RT 8/1 vs Arm 2) 20/10 vs Arm 3) 40/20
  • 1993 PMID 8262827 — "A randomized prospective trial of radiation therapy for AIDS-associated Kaposi's sarcoma." (Stelzer KJ, Int J Radiat Oncol Biol Phys. 1993 Dec 1;27(5):1057-61.)
    • Outcome: CR 40/20 83% vs. 20/10 79% vs. 8/1 50% (SS). Median time to failure 9.9 months vs. 6.0 months vs. 3.0 months (SS)
    • Conclusion: Higher doses resulted in improved response and control duration