title: Good tolerance and long-term complete remission after definitive intensity-modulated radiotherapy for locally advanced head and neck cancer in a patient with human immunodeficiency virus infection: A case report and literature review.
abstract: BACKGROUND
  The main concerns with radiation therapy for head and neck cancer in human immunodeficiency virus (HIV)-infected patients include limited tumor response and profound mucosal or skin toxicities under severe immunocompromised status.
  
  
  METHODS
  In this study, we describe the clinicopathological features, chronological changes in HIV viral loads and CD4 counts, and treatment outcomes of definitive radiotherapy for locally advanced head and neck cancer in an HIV-infected patient.
  
  
  RESULTS
  Despite low CD4 counts (80 cells/µL), a combination of highly active antiretroviral therapy (HAART) and definitive concurrent chemoradiotherapy (70 Gy of simultaneously integrated boost intensity-modulated radiotherapy (IMRT), fluorouracil, and leucovorin) was well-tolerated. Grade 3 mucositis and dermatitis were resolved 2 weeks after treatment completion. The patient was alive and remained disease-free 31 months after treatment.
  
  
  CONCLUSIONS
  For patients with HIV diagnosed with locally advanced head and neck cancer, good tolerance and outcome can be achieved with definitive radiotherapy while on HAART.
authors.affiliation: Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.|Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan.|Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Wan-Yu
authors.initials: WY
authors.lastname: Chen
authors.affiliation: Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan.|Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.|Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Sung-Hsin
authors.initials: SH
authors.lastname: Kuo
authors.affiliation: Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Taiwan.
authors.forename: Chia-Wei
authors.initials: CW
authors.lastname: Shen
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
authors.forename: Bing-Shen
authors.initials: BS
authors.lastname: Huang
authors.affiliation: Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.|Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Keng-Hsueh
authors.initials: KH
authors.lastname: Lan
authors.affiliation: Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.|Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Hsiang-Kuang
authors.initials: HK
authors.lastname: Liang
authors.affiliation: Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.|Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan.|Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Chun-Wei
authors.initials: CW
authors.lastname: Wang
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006258:Head and Neck Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D016867:Immunocompromised Host; D007822:Laryngeal Neoplasms / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012074:Remission Induction; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects
keywords: CD4; head and neck cancer; human immunodeficiency virus; immunocompromised; radiotherapy