Öz
Objective: In our study, we evaluated the clinical characteristics and outcomes of treatment in patients with Kaposi’s sarcoma (KS).Methods: The patients undergoing radiotherapy (RT) because of the KS between the years 2005-2012 in Radiation Oncology Department of Dicle University Hospital were included. All patients underwent RT with different dose-fractionation schemes to increase quality of life and to palliate the symptoms. Patients with lesions in multiple regions underwent RT in the same or different dates. Responses to radiotherapy were recorded as complete or partial response. Results: Fourteen patients received radiotherapy because of f KS were evaluated retrospectively. Twenty two different regions of 14 patients underwent RT . Only one patient (4.5%) was performed RT to glans penis as a third region while performed to the two regions in six patients (27.3%). At irradiations, 6 MV and 10 MV photon energies with 6 MeV, 9 MeV and 12 MeV electron energy were used. Water phantom or bolus material was used to obtain a homogeneous dose distribution in the photon irradiation. RT dose administered to a total of 22 different regional was median 800 cGy (Range: 800-3000 cGy). Median number of RT fractions was 1 .When treatment response were evaluated stable disease was present in the 4 (18.1%) regions. Partial response was achieved in eight (36.4%) regions, complete response in 10 (45.5%). RT-related common lymphedema in the feet and legs was observed in the four (57.3%) regions in the acute period. Complication of pain was present in two (28.7%) regions.Conclusion: RT is an appropriate and effective treatment regimen in the palliative treatment of KS lesions. Excellent response rates of skin lesions may be obtained by RT. Lesions and symptoms such as itching may be lost after RT. Side effects such as edema and pain may be relieved by supportive treatment
Anahtar Kelimeler
Kaynakça
- Kaposi M. Idiopathisches multiples pigmentsarcom der haut. Arch Dermatol Syphilol 1892;4:265.
- Mohanna S, Maco V, Bravo F, Gotuzzo E. Epidemiology and clinical characteristics of classic Kaposi’s sarcoma, seroprevalence, and variants of human herpesvirus 8 in South
- America: a critical review of an old disease. Int J Infect Dis IJID Off Publ Int Soc Infect Dis 2005;9:239–250.
- Schwartz RA. Kaposi’s sarcoma: An update. J Surg Oncol 2004;87:146–151.
- Weissmann A, Linn S, Weltfriend S, Friedman-Birnbaum R. Epidemiological study of classic Kaposi’s sarcoma: a retrospective review of 125 cases from Northern Israel. J Eur Acad Dermatol Venereol JEADV 2000;14:91–95.
- Lo TC, Salzman FA, Smedal MI, Wright KA. Radiotherapy for Kaposi’s sarcoma. Cancer 1980;45:684–687.
- Hamilton CR, Cummings BJ, Harwood AR. Radiotherapy of Kaposi’s sarcoma. Int J Radiat Oncol Biol Phys 1986;12:1931–1935.
- Saw CB, Wen BC, Anderson K, et al. Dosimetric considerations
- of water-based bolus for irradiation of extremities. Med Dosim Off J Am Assoc Med Dosim 1998;23:292–295.
- Brambilla L, Boneschi V, Taglioni M, Ferrucci S. Staging of classic Kaposi’s sarcoma: a useful tool for therapeutic choices. Eur J Dermatol EJD 2003;13:83–86.
- Brenner B, Weissmann-Brenner A, Rakowsky E, et al. Classical
- Kaposi sarcoma: prognostic factor analysis of 248 patients. Cancer 2002;95:1982–1987.
- Kirova YM, Belembaogo E, Frikha H, et al. Radiotherapy in the management of epidemic Kaposi’s sarcoma: a retrospective study of 643 cases. Radiother Oncol 1998;46:19–22.
- Nisce LZ, Safai B, Poussin-Rosillo H. Once weekly total and subtotal skin electron beam therapy for Kaposi’s sarcoma. Cancer 1981;47:640–644.
- Holecek MJ, Harwood AR. Radiotherapy of Kaposi’s sarcoma. Cancer. 1978;41:1733–1738.
- Piedbois P, Frikha H, Martin L, et al. Radiotherapy in the management of epidemic Kaposi’s sarcoma. Int J Radiat Oncol Biol Phys 994;30:1207–1211.
- Chak LY, Gill PS, Levine AM, et al. Radiation therapy for acquired immunodeficiency syndrome-related Kaposi’s sarcoma. J Clin Oncol Off J Am Soc Clin Oncol 1988;6:863–867.
- Becker G, Bottke D. Radiotherapy in the management of Kaposi’s sarcoma. Onkologie 2006;29:329–333.
- Caccialanza M, Marca S, Piccinno R, Eulisse G. Radiotherapy of classic and human immunodeficiency virus-related Kaposi’s sarcoma: results in 1482 lesions. J Eur Acad Dermatol Venereol JEADV 2008;22:297–302.
- Akmansu M, Goksel F, Erpolat O. P, et al. The palliative radiotherapy
- of classic Kaposi’s Sarcoma of foot region: Retrospective evaluation. Int J Hematol Oncol 2014;24:147-152.
Öz
Amaç: Çalışmamızda Kaposi sarkomu (KS) tanısı nedeniyle radyoterapi (RT) uygulanan hastaların klinik özelliklerini ve tedavi sonuçlarını değerlendirdik.
Yöntemler: Çalışmaya Dicle Üniversitesi Hastanesi Radyasyon Onkolojisi Kliniği’nde 2005-2012 yılları arasında RT uygulanan KS tanılı hastalar dahil edildi. Tüm hastalara semptomların palyasyonu ve yaşam kalitesini arttırmak için farklı doz-fraksiyonasyon şemaları ile RT uygulandı. Birden çok bölgesinde lezyonu olan hastalara aynı veya farklı tarihlerde RT uygulandı. Hastaların radyoterapiye cevapları tam veya kısmi yanıt olarak kaydedildi.
Bulgular: KS nedeniyle radyoterapi uygulanan 14 hasta retrospektif olarak değerlendirildi. On dört hastanın toplam 22 farklı bölgesine RT uygulandı. Altı hastada (%27,3) iki ayrı bölge ışınlanırken, yalnız bir hastada (%4,5) üçüncü bölge olarak glans penisteki lezyona RT uygulandı. Işınlamalarda 6 MV ve 10 MV foton enerjileri ile 6 MeV, 9 MeV ve 12 MeV elektron enerjileri kullanıldı. Foton ışınlamalarında homojen doz dağılımı elde etmek için su fantomu veya bolus materyali kullanıldı. Uygulanan RT dozu toplam 22 farklı bölge için medyan 800 cGy (800-3000 cGy) idi. RT fraksiyon sayısı medyan 1’di (1-10). Tedavi yanıtları değerlendirildiğinde 4 (%18,1) bölgede stabil hastalık mevcuttu. Sekiz (%36,4) tedavi bölgesinde kısmi cevap sağlanırken, 10 (%45,5) bölgede de tam cevap elde edildi. Dört (%57,3) tedavi bölgesinde RT’ ye bağlı ayaklarda ve bacaklarda akut dönemde yaygın lenfödem gözlendi. İki (%28,7) bölgede ise ağrı komplikasyonu mevcuttu.
Sonuç: RT, KS lezyonlarının palyatif tedavisinde uygun ve etkili bir tedavi rejimidir. RT ile cilt lezyonlarında mükemmel cevap oranları elde edilebilir. RT sonrası lezyonlar ve kaşıntı gibi şikayetler kaybolabilir. Ağrı, ödem gibi yan etkiler destek tedavi ile giderilebilir.
Anahtar kelimeler: Kaposi sarkomu, radyoterapi, doz-fraksiyon şeması
Anahtar Kelimeler
Kaynakça
- Kaposi M. Idiopathisches multiples pigmentsarcom der haut. Arch Dermatol Syphilol 1892;4:265.
- Mohanna S, Maco V, Bravo F, Gotuzzo E. Epidemiology and clinical characteristics of classic Kaposi’s sarcoma, seroprevalence, and variants of human herpesvirus 8 in South
- America: a critical review of an old disease. Int J Infect Dis IJID Off Publ Int Soc Infect Dis 2005;9:239–250.
- Schwartz RA. Kaposi’s sarcoma: An update. J Surg Oncol 2004;87:146–151.
- Weissmann A, Linn S, Weltfriend S, Friedman-Birnbaum R. Epidemiological study of classic Kaposi’s sarcoma: a retrospective review of 125 cases from Northern Israel. J Eur Acad Dermatol Venereol JEADV 2000;14:91–95.
- Lo TC, Salzman FA, Smedal MI, Wright KA. Radiotherapy for Kaposi’s sarcoma. Cancer 1980;45:684–687.
- Hamilton CR, Cummings BJ, Harwood AR. Radiotherapy of Kaposi’s sarcoma. Int J Radiat Oncol Biol Phys 1986;12:1931–1935.
- Saw CB, Wen BC, Anderson K, et al. Dosimetric considerations
- of water-based bolus for irradiation of extremities. Med Dosim Off J Am Assoc Med Dosim 1998;23:292–295.
- Brambilla L, Boneschi V, Taglioni M, Ferrucci S. Staging of classic Kaposi’s sarcoma: a useful tool for therapeutic choices. Eur J Dermatol EJD 2003;13:83–86.
- Brenner B, Weissmann-Brenner A, Rakowsky E, et al. Classical
- Kaposi sarcoma: prognostic factor analysis of 248 patients. Cancer 2002;95:1982–1987.
- Kirova YM, Belembaogo E, Frikha H, et al. Radiotherapy in the management of epidemic Kaposi’s sarcoma: a retrospective study of 643 cases. Radiother Oncol 1998;46:19–22.
- Nisce LZ, Safai B, Poussin-Rosillo H. Once weekly total and subtotal skin electron beam therapy for Kaposi’s sarcoma. Cancer 1981;47:640–644.
- Holecek MJ, Harwood AR. Radiotherapy of Kaposi’s sarcoma. Cancer. 1978;41:1733–1738.
- Piedbois P, Frikha H, Martin L, et al. Radiotherapy in the management of epidemic Kaposi’s sarcoma. Int J Radiat Oncol Biol Phys 994;30:1207–1211.
- Chak LY, Gill PS, Levine AM, et al. Radiation therapy for acquired immunodeficiency syndrome-related Kaposi’s sarcoma. J Clin Oncol Off J Am Soc Clin Oncol 1988;6:863–867.
- Becker G, Bottke D. Radiotherapy in the management of Kaposi’s sarcoma. Onkologie 2006;29:329–333.
- Caccialanza M, Marca S, Piccinno R, Eulisse G. Radiotherapy of classic and human immunodeficiency virus-related Kaposi’s sarcoma: results in 1482 lesions. J Eur Acad Dermatol Venereol JEADV 2008;22:297–302.
- Akmansu M, Goksel F, Erpolat O. P, et al. The palliative radiotherapy
- of classic Kaposi’s Sarcoma of foot region: Retrospective evaluation. Int J Hematol Oncol 2014;24:147-152.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 24 Ekim 2015 |
| Gönderilme Tarihi | 24 Ekim 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 42 Sayı: 3 |