Low-dose radiotherapy as a definitive treatment for Kimura's disease.

Abstract

Purpose: Kimura disease (KD) is characterized by inflammatory granulomas with eosinophilic infiltration in young males. The characteristic large mass in the head and neck region poses esthetic concerns. Treatment may include corticosteroid administration, surgery, or both; however, these often result in recurrence. Low-dose radiation therapy (RT) is a second-line treatment option for KD and is mainly used for recurrence or as adjuvant therapy after surgery. In this study, we aimed to evaluate the outcomes of RT alone as a definitive treatment for seven patients with KD refractory to oral corticosteroids.

Methods: This study included male patients with a median age of 37 years and median disease duration of 9 years. The lesion sites included the unilateral or bilateral cheek and auricular areas. RT was administered at a dose of 1.8 Gy per fraction five times per week for a total of 30.6 Gy. Their adverse events and predictive biomarkers were evaluated.

Results: The maximal diameter of the mass significantly reduced from 10 ± 3.8 cm (mean ± SD) to 4.1 ± 1.9 cm without regrowth for 99 months. Peripheral blood eosinophil counts significantly decreased from 2,435 ± 241 to 1,106 ± 411/µL at one year after RT. The acute adverse events included grade 1 dermatitis and dry mouth in five patients, pharyngitis in 3, and alopecia in 2, all of which improved a few months after RT.

Conclusion: RT is a satisfactory treatment for patients with corticosteroid-resistant KD with acceptable adverse events. The peripheral blood eosinophil count may be a useful biomarker for determining the disease status of KD.