Primary radiation therapy for head-and-neck cancer in the setting of human immunodeficiency virus.
OBJECTIVE
To analyze outcomes after radiation therapy for head-and-neck cancer among a cohort of patients with human immunodeficiency virus (HIV).


METHODS
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.
Klein
Emily A
EA
Department of Radiation Oncology, University of California Davis Cancer Center, Sacramento, CA, USA.
Guiou
Michael
M
Farwell
D Gregory
DG
Luu
Quang
Q
Lau
Derick H
DH
Stuart
Kerri
K
Vaughan
Andrew
A
Vijayakumar
Srinivasan
S
Chen
Allen M
AM
D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy / Q000379:methods; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D016867:Immunocompromised Host; D017567:Karnofsky Performance Status; D052016:Mucositis / Q000209:etiology / Q000473:pathology; D011855:Radiodermatitis / Q000209:etiology / Q000473:pathology; D050397:Radiotherapy, Intensity-Modulated; D015431:Weight Loss
D019380:Anti-HIV Agents