Abstract:
AIM:To report the outcome of radiation therapy (RT) +/- chemotherapy in HIV-seropositive patients with Head and Neck Squamous Cell Carcinoma (HNSCC). PATIENTS AND METHODS:This is the largest single-Institution retrospective study to date, consisting of 73 HIV patients with HNSCC treated from January 1997-2010. The median age at RT, HIV diagnosis and the duration of patients being HIV seropositive were 51, 34, and 11 years, respectively. Seventy patients had SCC and one had submandibular salivary duct carcinoma. Stages I-II, III and IVA/B were: 22%, 27% and 51%, respectively. Primary cancer sites comprised the larynx (37%), oropharynx (32%), oral cavity (13%), hypopharynx (7%), nasopharynx (4%), unknown primary (MUP) (4%), nasal cavity (3%), and submandibular salivary duct (1%). All patients had an ECOG performance scale of ≤1 and were treated with RT +/- chemotherapy. Fifty patients (70%) were on highly active anti-retroviral therapy (HAART) during treatment, and the median CD4 count was 290 (range: 203-1142). Median dose of 70, 63, and 54 Gy were delivered to the gross disease, high-risk neck, and low-risk neck respectively. Median duration of treatment was 52 (range: 49-64) days. Twelve patients (17%) underwent neck dissection for N3 disease. RESULTS:After a median follow-up of 47 months (range: 7-140), the 4-year locoregional control (LRC) and overall survival (OS) were 69% and 55% respectively. Seven patients (10%) developed second primary sites within the first 5 years of completing RT (2 anal SCCs and 5 HNSCCs). The LRC for Stages III/IV larynx and oropharynx SCC (which represent the majority of the cohort) were 76% and 70%, respectively. Chemo/RT-related late toxicities were dysphagia of grade≤2, 3, and 4 found in 74%, 15% and 11% of patients, respectively. Hoarseness (grade 1) was reported in 10% of patients; no patient experienced grade ≥2. Xerostomia grade ≤2, and 3 was found in 77% and 23% of patients, respectively. A Chi-square test and univariate analysis showed statistically significant relationships between LRC and duration of RT (p<0.001), as well as positive trends for weight loss (<10%) and absence of second malignancy. CONCLUSION:Definitive RT +/- chemotherapy for HIV-seropositive patients with HNSCC appears to be less effective compared to the observed rates of LRC and OS of other HNSCC without HIV. Due to advances in the HAART which prolongs HIV patients' survival, it is extremely important to establish better treatment strategies to improve therapeutic ratio in this growing patient population.
journal_name
Anticancer Resjournal_title
Anticancer researchauthors
Mourad WF,Hu KS,Shasha D,Concert C,Ishihara D,Lin W,Gamez ME,Lukens JN,Shourbaji RA,Ryniak M,Li Z,Culliney BE,Khorsandi AS,Tran T,Jacobson A,Manolidis S,Schantz S,Urken M,Persky MS,Harrison LBsubject
Has Abstractpub_date
2013-12-01 00:00:00pages
5511-6issue
12eissn
0250-7005issn
1791-7530pii
33/12/5511journal_volume
33pub_type
杂志文章abstract::Bone metastases are a sign of advanced tumor disease. Surgical therapy is only occasionally curative. Therefore, the therapeutic goals are a limited surgical excision, immediate mobilization, effective stabilization and the avoidance of local recurrence. We investigated the effect of the anthracycline daunorubicin (DN...
journal_title:Anticancer research
pub_type: 杂志文章
doi:
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journal_title:Anticancer research
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:1995-09-01 00:00:00
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journal_title:Anticancer research
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更新日期:2000-09-01 00:00:00
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pub_type: 历史文章,杂志文章
doi:
更新日期:2013-09-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:2008-01-01 00:00:00
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更新日期:2017-10-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:1997-09-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:2006-11-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
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pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:2013-06-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:2009-07-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:2003-05-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:1990-05-01 00:00:00
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pub_type: 杂志文章,多中心研究
doi:
更新日期:2009-05-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2018-03-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:2016-01-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章,评审
doi:
更新日期:2011-02-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:1999-05-01 00:00:00
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journal_title:Anticancer research
pub_type: 杂志文章
doi:
更新日期:2015-04-01 00:00:00