Primary radiation therapy for head-and-neck cancer in the setting of human immunodeficiency virus

Emily A. Klein, Michael Guiou, D Gregory Farwell, Quang Luu, Derick H Lau, Kerri Stuart, Andrew T M Vaughan, Srinivasan Vijayakumar, Allen M. Chen

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Purpose: To analyze outcomes after radiation therapy for head-and-neck cancer among a cohort of patients with human immunodeficiency virus (HIV). Methods and Materials: The medical records of 12 patients with serologic evidence of HIV who subsequently underwent radiation therapy to a median dose of 68 Gy (range, 64-72 Gy) for newly diagnosed squamous cell carcinoma of the head and neck were reviewed. Six patients (50%) received concurrent chemotherapy. Intensity-modulated radiotherapy was used in 6 cases (50%). All patients had a Karnofsky performance status of 80 or 90. Nine patients (75%) were receiving antiretroviral therapies at the time of treatment, and the median CD4 count was 460 (range, 266-800). Toxicity was graded according to the Radiation Therapy Oncology Group / European Organization for the Treatment of Cancer toxicity criteria. Results: The 3-year estimates of overall survival and local-regional control were 78% and 92%, respectively. Acute Grade 3+ toxicity occurred in 7 patients (58%), the most common being confluent mucositis (5 patients) and moist skin desquamation (4 patients). Two patients experienced greater than 10% weight loss, and none experienced more than 15% weight loss from baseline. Five patients (42%) experienced treatment breaks in excess of 10 cumulative days, although none required hospitalization. There were no treatment-related fatalities. Conclusions: Radiation therapy for head-and-neck cancer seems to be relatively well tolerated among appropriately selected patients with HIV. The observed rates of toxicity were comparable to historical controls without HIV.

Original languageEnglish (US)
Pages (from-to)60-64
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Volume79
Issue number1
DOIs
StatePublished - Jan 1 2011

Keywords

  • Head-and-neck cancer
  • Human immunodeficiency virus
  • Immunosuppression
  • Radiotherapy
  • Toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

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