title: Tolerance and toxicity of primary radiation therapy in the management of seropositive HIV patients with squamous cell carcinoma of the head and neck.
abstract: OBJECTIVE
  To report tolerance and toxicity of radiotherapy (RT) with or without chemotherapy in HIV seropositive patients with squamous cell carcinoma of the head and neck (SCCHN).
  
  
  METHODS
  This is a single institution retrospective study of 73 HIV seropositive patients with SCCHN treated from January 1997 through 2010. Stages I, II, III, and IV were 8%, 10%, 24%, and 58%, respectively. The median age at RT, HIV diagnosis. and the duration of HIV seropositive were 51 (32-72), 34 (25-50), and 11 (6-20) years, respectively. Patients were treated definitively with RT alone (35%) or concurrent chemo-RT (65%). Median dose of 70 Gy (66-70) was delivered to the gross disease. Median duration of treatment was 52 (49-64) days. Fifty patients (70%) were on HAART.
  
  
  RESULTS
  RT± chemotherapy induced acute toxicity was: median weight loss 20 pounds (6-40), 100% developed dysgeusia and xerostomia (grades 1-3). Acute mucositis and dysphagia/odynophagia grades ≤ 2 and 3 were 83% and 17%, respectively. Treatment breaks in excess of 10, 7, and 3 days were found in 5%, 13%, and 15% of patients, respectively. With a median follow-up of 4 years (2-12) the RT ±chemotherapy induced late dysphagia and xerostomia grades >2 were 26% and 23% of patients, respectively.
  
  
  CONCLUSIONS
  Our data show that primary RT ±chemotherapy for HIV seropositive SCCHN is less tolerated compared to the historical data for SCCHN without HIV.
  
  
  METHODS
  2b.
authors.affiliation: Department of Radiation Oncology, Beth Israel Medical Center, New York, New York, USA. Waleed246@gmail.com
authors.forename: Waleed F
authors.initials: WF
authors.lastname: Mourad
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Hu
authors.forename: Dan
authors.initials: D
authors.lastname: Ishihara
authors.forename: Rania A
authors.initials: RA
authors.lastname: Shourbaji
authors.forename: Wilson
authors.initials: W
authors.lastname: Lin
authors.forename: Mahesh
authors.initials: M
authors.lastname: Kumar
authors.forename: Adam S
authors.initials: AS
authors.lastname: Jacobson
authors.forename: Theresa
authors.initials: T
authors.lastname: Tran
authors.forename: Spiros
authors.initials: S
authors.lastname: Manolidis
authors.forename: Mark
authors.initials: M
authors.lastname: Urken
authors.forename: Mark
authors.initials: M
authors.lastname: Persky
authors.forename: Louis
authors.initials: L
authors.lastname: Harrison
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis / Q000532:radiotherapy*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications*; D006258:Head and Neck Neoplasms / Q000150:complications / Q000175:diagnosis / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011836:Radiation Tolerance; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D014481:United States / Q000453:epidemiology; D014987:Xerostomia / Q000453:epidemiology / Q000209:etiology*