Topics:
Head and Neck Cancers • Radiation Oncology
What dose and fractionation would you use for Kaposi’s sarcoma of the tonsil post op?
I have an interesting case of gentleman in his 40s, HIV+ but viral count undetectable and CD4 1000+. He had prior diagnosis of Kaposi’s sarcoma of leg treated with Doxil in 2015.
Now he presented with enlarging right tonsillar mass and he was referred to ENT and underwent bilateral tonsillectomy. Right tonsil shows Kaposi’s sarcoma with positive margin.
Post op CT scans shows no evidence of other concerning lesions throughout the body. Med onc is not keen to give chemo again and referred to us for radiation.
Any thoughts on best way to treat this case?
Answer from: Radiation Oncologist at Community Practice
36 Gy/2 Gy X 18 to the surgical bed with IGRT and 40 Gy/20 to the positive margin area based on pre-op images with 10 mm margin for CTV expansion and 3-5 mm with CTV-PTV expansion. Quéro et al., PMID 35454820 Cihan, PMID 29383006
Sign in or Register to read more