What is the role of radiation therapy in the treatment of Kaposi sarcoma (KS)?

Updated: Apr 11, 2019
  • Author: Jessica Katz, MD, PhD, FACP; Chief Editor: Edwin Choy, MD, PhD  more...
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Answer

Radiation therapy

Radiation therapy is the most widely used and effective local therapy. [97]  It can palliate bleeding, pain, and unsightly lesions. Kaposi sarcoma is very radiosensitive, with reported response rates of 68%-92%. A study assessing the efficacy of radiation on 97 previously untreated cutaneous Kaposi sarcoma lesions showed a response rate of 87% with a complete response seen in 30% of treated sites. [98]  

The type and dose of radiation varies depending on site, depth, and diameter of lesion. Low-voltage (100 kv) photons or electron-beam radiotherapy may be used. The standard regimen is 24 Gy in 12 fractions; however, hypofractionated regimens (eg, 20 Gy in 5 fractions) have shown to be equally effective. [99] Patients with HIV are more prone to develop radiation-induced mucositis as well as hyperpigmentation, desquamation, and ulceration of treated lesions. [31, 100, 101]

In patients with widespread skin involvement, extended-field external beam radiation therapy (EBRT) has been effective in controlling the disease. This approach appears to give better long-term control than piecemeal radiation of individual lesions. This form of therapy is also given in 4-Gy fractions weekly for 6-8 weeks.


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