Radiation therapy for HIV-associated diffuse large cell non-Hodgkin lymphoma.
OBJECTIVE
To report the clinical experience with external beam radiotherapy (RT) for AIDS-related lymphoma (ARL) with or without the involvement of the central nervous system (CNS) in HIV-infected patients.


METHODS
Clinical outcome of 24 HIV-seropositive patients with ARL treated with RT from 1995 to 2004 was reviewed, testing factors associated with outcome.


RESULTS
After 1 and 5 years, the overall survival was 65% and 35%, respectively. The mean RT dose was 31 Gy after normalization to fractions of daily 2 Gy (range, 7.8-47.2 Gy). Radiotherapy dose was associated with survival in univariate (P = .04) and multivariate analysis (P = .01). Other factors in univariate analysis associated with outcome were viral load (VL), highly active antiretroviral therapy (HAART), ARL stage, and CNS involvement. Patients with CNS involvement achieved complete response in 46% and improved clinical performance was seen in 73%.


CONCLUSIONS
After chemotherapy, RT in combination with HAART is highly active, and RT should be encouraged especially after suboptimal responses to induction treatment.
Rothschild
Sacha
S
Radiation Oncology, Zurich University Hospital, University of Zurich, Zurich, Switzerland. sacha.rothschild@dkf.unibe.ch
Dolder
Mathias
M
Seifert
Burkhardt
B
Lütolf
Urs M
UM
Ciernik
I Frank
IF
D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D016543:Central Nervous System Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D006679:HIV Seropositivity; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D016019:Survival Analysis; D019562:Viral Load