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. 2017 Dec;9(6):561-565.
doi: 10.5114/jcb.2017.72053. Epub 2017 Dec 30.

High-dose-rate brachytherapy in the treatment of skin Kaposi sarcoma

María Ángeles González Ruiz  1 , Juan Quirós Rivero  1 , Julia Luisa Muñoz García  1 , Joaquín José Cabrera Rodríguez  1 , Yesika Ríos Kavadoy  1 , María Francisca Ropero Carmona  1 , Almudena Corbacho Campos  1 , Fernando García Urra  1 , María Cristina Cruz Muñoz  1 , Amanda Ruiz Herrero  1 , Pedro Almendral Manzano  2
Affiliations

High-dose-rate brachytherapy in the treatment of skin Kaposi sarcoma

María Ángeles González Ruiz et al. J Contemp Brachytherapy. 2017 Dec.

Abstract

Purpose: The aim of the study is to review our experience in treatment of Kaposi sarcoma (KS) lesions with high-dose-rate (HDR) brachytherapy.

Material and methods: We present five new KS lesions (three patients) that were treated in our hospital from May 2016 to February 2017 with HDR brachytherapy using Valencia applicators. The treatment was delivered in 5 Gy fractions over five sessions, on alternate days. Total dose of 25 Gy (EQD2 31.25 Gy) was delivered. All patients were male, Caucasian, without a history of HIV, organ transplantation, or current immunosuppressive therapy. The median age was 76 years.

Results: All lesions (100%) were located in lower limbs (60% in the ankle, 20% in the leg, and 20% in the foot), and their development was progressive. No lesion was greater than 2 cm (range, 0.5-1.5 cm). With a median follow-up of 15 months, all patients had a complete response to the treatment, with no evidence of local recurrence or tumor progression. Most of the patients (80%) had no acute toxicity; only one patient developed erythema grade 2.

Conclusions: HDR brachytherapy could be a good option of treatment for these types of lesions, especially in elderly patients, or when cosmetic results are not good after surgery. Brachytherapy with the Valencia applicator, using hypofractionated regimen provides excellent results in terms of cosmetic and local control, and furthermore, facilitates treatment compliance, which is very relevant in elderly patients. HDR brachytherapy offers a simple, safe, quick, and attractive non-surgical treatment option.

Keywords: Kaposi sarcoma; Valencia applicator; brachytherapy; skin cancer.

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Conflict of interest statement

Autohors report no conflict of interest.

Figures

Fig. 1
Fig. 1
Valencia applicator template of 2 cm. The outer discontinuous fenestrations help to delimit with a marker the exact position of the Valencia applicator
Fig. 2
Fig. 2
Valencia applicator with 2 cm of diameter (H2). Fixation system with tape
Fig. 3
Fig. 3
Three superficial Kaposi sarcoma lesions of 1 cm localized in the ankle
Fig. 4
Fig. 4
Three months post-treatment results. Regression of the Kaposi sarcoma lesion
Fig. 5
Fig. 5
Six months post-treatment results. Resolution of the Kaposi sarcoma lesion
See this image and copyright information in PMC

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