title: Matched cohort analysis of outcomes of definitive radiotherapy for prostate cancer in human immunodeficiency virus-positive patients.
abstract: OBJECTIVE
  To compare the biochemical outcome and toxicity scores of men with human immunodeficiency virus (HIV) and prostate cancer with a matched control population with negative or unknown HIV status when treated with external-beam radiotherapy (EBRT).
  
  
  METHODS
  A single-institution database of men with prostate cancer treated with EBRT from 1999 to 2009 was reviewed. Thirteen men with HIV were identified and matched to 2 control patients according to age, race, T stage, prostate-specific antigen level, Gleason score, RT dose, intensity-modulated RT vs. three-dimensional conformal RT, and whole-pelvis vs. prostate-only RT, for a total of 39 cases. The median follow-up time was 39 months (range, 3-110 months).
  
  
  RESULTS
  The 4-year biochemical failure (BF)-free survival rate was 87% in the HIV-positive group vs. 89% in the controls (p = 0.94). Pre- and post-RT viral loads were found to be predictive of BF (p = 0.04 and p = 0.04, respectively). No men with HIV died, whereas 2 in the control group died of causes unrelated to prostate cancer. Acute and chronic genitourinary and gastrointestinal toxicity were less in the HIV-positive patients than in controls (p < 0.001, p < 0.001, p = 0.003, and p < 0.001, respectively). The HIV-positive men experienced an average decline in CD4 count of 193 cells/mm(3).
  
  
  CONCLUSIONS
  Our findings suggest that men with HIV treated with EBRT have a similar risk of BF; however, high viral loads may contribute to an increased risk. This analysis supports that HIV-positive men with prostate cancer can be treated with definitive EBRT with similar disease control and toxicity outcomes as in the general population.
authors: Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA. shannonkahn@yahoo.com
authors: Shannon
authors: S
authors: Kahn
authors: Ashesh
authors: A
authors: Jani
authors: Scott
authors: S
authors: Edelman
authors: Peter
authors: P
authors: Rossi
authors: Karen
authors: K
authors: Godette
authors: Jerome
authors: J
authors: Landry
authors: Cynthia
authors: C
authors: Anderson
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D015331:Cohort Studies; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D041981:Gastrointestinal Tract / Q000528:radiation effects; D006679:HIV Seropositivity / Q000150:complications* / Q000208:ethnology / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000150:complications* / Q000208:ethnology / Q000473:pathology / Q000532:radiotherapy*; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D014566:Urogenital System / Q000528:radiation effects
chemical_list: D017430:Prostate-Specific Antigen