A randomized prospective trial of radiation therapy for AIDS-associated Kaposi's sarcoma
Identifieur interne : 001C58 ( Istex/Curation ); précédent : 001C57; suivant : 001C59A randomized prospective trial of radiation therapy for AIDS-associated Kaposi's sarcoma
Auteurs : Keith J. Stelzer [États-Unis] ; Thomas W. Griffin [États-Unis]Source :
- International Journal of Radiation Oncology, Biology, Physics [ 0360-3016 ] ; 1993.
English descriptors
- Teeft :
- Acute toxicity, Aids patients, Anatomical location, Chemotherapy, Complete response, Cosmetic reasons, Crude incidence, Cutaneous, Cutaneous kaposi, Cytotoxic chemotherapy, Epidemic kaposi, Exact test, First manifestation, Good response, High performance status, Higher dose, Higher proportion, Immune deficiency syndrome, Individual lesions, Individual patients, Kaposi, Late toxicity, Lesion, Lesion characteristics, Lesion control, Lesion failure, Lesion size, Median, Median time, Objective response, Oncol, Other sites, Palpable tumor, Partial response, Patient performance status, Proportional differences, Protracted treatment course, Radiation dose, Radiation oncology, Radiation regimens, Radiation therapy, Radiotherapy, Randomized study, Regimen, Sarcoma, Single dose, Skin erythema, Toxicity, Treatment intent, Tumor control, Tumor response.
Abstract
Abstract: Purpose: The optimal dose of radiation in the treatment of AIDS-associated Kaposi's sarcoma has been controversial based on previous nonrandomized retrospective studies.Methods and Materials: Seventy-one cutaneous AIDS-associated Kaposi's sarcoma lesions were randomly assigned to 1 of 3 radiation dose regimens-8 Gy in 1 fraction, 20 Gy in 10 fraction. and 40 Gy in 20 fractions. Lesions were measured prior to and following treatment. Complete resolution of palpable tumor was considered a complete response, regardless of residual purple pigmentation. Reduction in palpable tumor to less than 50% of pretreatment area was considered an objective response. Less than 50% reduction in tumor size was considered a nonresponse.Results: Complete response was higher (p = .04) with 40 Gy (83%) and 20 Gy (79%) than with 8 Gy (50%). Absence of residual purple pigmentation was greater (p = .005) with 40 Gy (43%) than with 20 Gy (8%) or 8 Gy (8%). Lesion failure was lower (p = .03) with 40 Gy (52%) than with 20 Gy (67%) or 8 Gy (88%). Median time to failure was 43 weeks with 40 Gy, 26 weeks with 20 Gy, and 13 weeks with 8 Gy (p = .003).Conclusion: Fractionated radiotherapy to higher total doses resulted in improved response and control of cutaneous Kaposi's sarcoma. This dose-dependence should be considered in determining the optimal radiotherapeutic regimen for individual patients treated for epidemic Kaposi's sarcoma.
Url:
DOI: 10.1016/0360-3016(93)90523-X
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>A randomized prospective trial of radiation therapy for AIDS-associated Kaposi's sarcoma</title><author><name sortKey="Stelzer, Keith J" sort="Stelzer, Keith J" uniqKey="Stelzer K" first="Keith J." last="Stelzer">Keith J. Stelzer</name><affiliation wicri:level="1"><mods:affiliation>Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA 98195, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA 98195</wicri:regionArea></affiliation></author><author><name sortKey="Griffin, Thomas W" sort="Griffin, Thomas W" uniqKey="Griffin T" first="Thomas W." last="Griffin">Thomas W. Griffin</name><affiliation wicri:level="1"><mods:affiliation>Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA 98195, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA 98195</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:DDDCADE1BD5C73E76267EB6DCB1E821AD15A95C0</idno><date when="1993" year="1993">1993</date><idno type="doi">10.1016/0360-3016(93)90523-X</idno><idno type="url">https://api.istex.fr/ark:/67375/6H6-MMDNXDWP-W/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">001C58</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001C58</idno><idno type="wicri:Area/Istex/Curation">001C58</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">A randomized prospective trial of radiation therapy for AIDS-associated Kaposi's sarcoma</title><author><name sortKey="Stelzer, Keith J" sort="Stelzer, Keith J" uniqKey="Stelzer K" first="Keith J." last="Stelzer">Keith J. Stelzer</name><affiliation wicri:level="1"><mods:affiliation>Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA 98195, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA 98195</wicri:regionArea></affiliation></author><author><name sortKey="Griffin, Thomas W" sort="Griffin, Thomas W" uniqKey="Griffin T" first="Thomas W." last="Griffin">Thomas W. Griffin</name><affiliation wicri:level="1"><mods:affiliation>Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA 98195, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA 98195</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">International Journal of Radiation Oncology, Biology, Physics</title><title level="j" type="abbrev">ROB</title><idno type="ISSN">0360-3016</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1993">1993</date><biblScope unit="volume">27</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="1057">1057</biblScope><biblScope unit="page" to="1061">1061</biblScope></imprint><idno type="ISSN">0360-3016</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0360-3016</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Acute toxicity</term><term>Aids patients</term><term>Anatomical location</term><term>Chemotherapy</term><term>Complete response</term><term>Cosmetic reasons</term><term>Crude incidence</term><term>Cutaneous</term><term>Cutaneous kaposi</term><term>Cytotoxic chemotherapy</term><term>Epidemic kaposi</term><term>Exact test</term><term>First manifestation</term><term>Good response</term><term>High performance status</term><term>Higher dose</term><term>Higher proportion</term><term>Immune deficiency syndrome</term><term>Individual lesions</term><term>Individual patients</term><term>Kaposi</term><term>Late toxicity</term><term>Lesion</term><term>Lesion characteristics</term><term>Lesion control</term><term>Lesion failure</term><term>Lesion size</term><term>Median</term><term>Median time</term><term>Objective response</term><term>Oncol</term><term>Other sites</term><term>Palpable tumor</term><term>Partial response</term><term>Patient performance status</term><term>Proportional differences</term><term>Protracted treatment course</term><term>Radiation dose</term><term>Radiation oncology</term><term>Radiation regimens</term><term>Radiation therapy</term><term>Radiotherapy</term><term>Randomized study</term><term>Regimen</term><term>Sarcoma</term><term>Single dose</term><term>Skin erythema</term><term>Toxicity</term><term>Treatment intent</term><term>Tumor control</term><term>Tumor response</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Purpose: The optimal dose of radiation in the treatment of AIDS-associated Kaposi's sarcoma has been controversial based on previous nonrandomized retrospective studies.Methods and Materials: Seventy-one cutaneous AIDS-associated Kaposi's sarcoma lesions were randomly assigned to 1 of 3 radiation dose regimens-8 Gy in 1 fraction, 20 Gy in 10 fraction. and 40 Gy in 20 fractions. Lesions were measured prior to and following treatment. Complete resolution of palpable tumor was considered a complete response, regardless of residual purple pigmentation. Reduction in palpable tumor to less than 50% of pretreatment area was considered an objective response. Less than 50% reduction in tumor size was considered a nonresponse.Results: Complete response was higher (p = .04) with 40 Gy (83%) and 20 Gy (79%) than with 8 Gy (50%). Absence of residual purple pigmentation was greater (p = .005) with 40 Gy (43%) than with 20 Gy (8%) or 8 Gy (8%). Lesion failure was lower (p = .03) with 40 Gy (52%) than with 20 Gy (67%) or 8 Gy (88%). Median time to failure was 43 weeks with 40 Gy, 26 weeks with 20 Gy, and 13 weeks with 8 Gy (p = .003).Conclusion: Fractionated radiotherapy to higher total doses resulted in improved response and control of cutaneous Kaposi's sarcoma. This dose-dependence should be considered in determining the optimal radiotherapeutic regimen for individual patients treated for epidemic Kaposi's sarcoma.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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