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Outcomes and tolerance of human immunodeficiency virus--positive U.S. veterans undergoing dose-escalated external beam radiotherapy for localized prostate cancer.

Abstract：

INTRODUCTION:There are little data on the outcomes and tolerance, as well as the impact on the CD4 counts, of human immunodeficiency virus (HIV)-positive patients with prostate cancer who undergo high-dose external beam radiotherapy. MATERIALS AND METHODS:We identified 15 HIV-positive patients with prostate cancer who were treated with external beam radiation to a dose ≥ 75.6 Gy at the New York Harbor Department of Veterans Affairs between 2003 and 2010. Kaplan-Meier analyses were used to measure biochemical control outcomes. Toxicity and CD4 counts before, after, and during treatments were analyzed. RESULTS:A total of 15 patients were identified, with a median follow-up period of 49 months. There were 2 biochemical failures, which occurred at 28 months and 63 months, respectively. In neither of these 2 patients was there evidence of metastatic disease. The overall 5-year biochemical control was 92.3%. There appeared to be a consistent decline in the CD4 counts both during and immediately after the radiation treatments. Most of these patients had a subsequent improvement in their CD4 counts. Toxicity was mild overall, though there was 1 patient who developed rectal bleeding 11 months post treatment, which required argon plasma coagulation. CONCLUSION:Dose-escalated external beam radiation is well tolerated in HIV-positive patients with durable biochemical control and mild toxicity. A substantial decline in CD4 counts is associated with the radiation; therefore, these counts need to be monitored closely, in conjunction with the infectious-disease specialist.

journal_name

Clin Genitourin Cancer

journal_title

Clinical genitourinary cancer

authors

Schreiber D,Chhabra A,Rineer J,Nabhani T,Katsoulakis E,Morkos R,Rotman M,Schwartz D

doi

10.1016/j.clgc.2013.07.008

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

94-9

issue

2

eissn

1558-7673

issn

1938-0682

pii

S1558-7673(13)00198-5

journal_volume

12

pub_type

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