I would advocate chemotherapy first. Pegylated adriamycin was very effective in the past but may have been surpassed. I would get a good medical oncology opinion first. If chemo has been exhausted. radiation could be considered.To treat a whole limb with photons will be difficult but I have treated the lower half of the lower limb below knee using a water bath to ensure a homegenous dose distribution and into which the person stands and then two parallel opposed fields. I would prefer localised electron fields if possible. I would suggest treating the inguinal nodes with a separate technique. Side effects will depend on dose but, as KS is relatively sensitive to low doses and such are used, side effects may be limited. The biggest problem will be oedema from the lymphadenopathy.

Thank you very much, Dr. Alan Rodger. I did exactly what you suggested, and the patient is going to do chemotherapy firstly - it has medical conditions to do it. But, sometimes, due to comorbidities and age, patients are only able to do radiotherapy. We have already irradiated halves of members, but never to an extent so great. Thanks for the water bath idea.

Thank you, Dr. Glenn Wayne Jones! I will take into consideration your suggestion.