title: HIV infection and invasive cervical cancers, treatment with radiation therapy: toxicity and outcome.
abstract: OBJECTIVE
  To determine the effect of radiotherapy in HIV seropositive cervical cancer patients, tumour response and toxicity and compliance of patients to the treatment.
  
  
  METHODS
  This study is a retrospective review of 42 HIV seropositive patients diagnosed with carcinoma cervix, between 1997 and 2003 at the Tata Memorial Hospital. The age and symptoms of presentation, clinical stage, response, compliance and tolerance to radiotherapy were studied.
  
  
  RESULTS
  Mean age at presentation was 41 years. All patients presented with the symptoms of cervical disease. Of these patients 31(74%) patients had 'Karnofsky Performance Scale' (KPS) more than 80%. Twenty-one (50%) of the patients were of Stage IIIb-IVa. Thirty-two (76%) were started on radiotherapy with radical intent. Compliance to radiotherapy was poor with 24% patients discontinuing after few fractions of radiotherapy. Seven (17%) patients were given palliative radiotherapy. Twenty-two patients completed prescribed radical radiotherapy and 50% of these achieved complete response. Grade III-IV acute gastrointestinal toxicity was seen in 14% of the patients, and grade III acute skin toxicity was seen in 27% of patients, leading to treatment delays. There was good relief of symptoms in patients treated with palliative intent.
  
  
  CONCLUSIONS
  Radiotherapy is effective in this set of patients. Palliative fractionation schedules are effective for patients with poor performance status and locally advanced cancers in relieving the symptoms related to carcinoma cervix. An emphasis should be given to the increased acute mucosal and skin toxicity and to improving compliance and clinical outcome of these patients.
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai 400012, India.
authors.forename: Shyam Kishore
authors.initials: SK
authors.lastname: Shrivastava
authors.forename: Reena
authors.initials: R
authors.lastname: Engineer
authors.forename: Sunil
authors.initials: S
authors.lastname: Rajadhyaksha
authors.forename: Ketayun A
authors.initials: KA
authors.lastname: Dinshaw
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000150:complications / Q000532:radiotherapy* / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D011832:Radiation Injuries; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000821:virology*