Completion of and early response to chemoradiation among human immunodeficiency virus (HIV)-positive and HIV-negative patients with locally advanced cervical carcinoma in South Africa

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dc.contributor.authorSimonds H.M.
dc.contributor.authorWright J.D.
dc.contributor.authorDu Toit N.
dc.contributor.authorNeugut A.I.
dc.contributor.authorJacobson J.S.
dc.date.accessioned2012-06-06T08:04:24Z
dc.date.available2012-06-06T08:04:24Z
dc.date.issued2012
dc.description.abstractBACKGROUND: Very few published studies have dealt with the management of locally advanced cervix carcinoma among human immunodeficiency virus (HIV)-positive patients. The objective of this study was to compare the clinical characteristics, radiation and chemotherapy treatments, and outcomes in a cohort of HIV-positive and HIV-negative women with cervical cancer. METHODS: The authors reviewed the charts of 59 HIV-positive patients and 324 HIV-negative patients who had stage IB1 to IIIB cervical carcinoma and who received radiation therapy. Demographic and clinical characteristics were compared at the time of diagnosis; and radiation doses, chemotherapy cycles, and responses were compared at the time of brachytherapy and at 6-week follow-up. Logistic regression models of response to treatment were developed. RESULTS: Forty-nine HIV-positive patients (88.1%) but only 213 HIV-negative patients (65.7%) presented with stage IIIB disease (P =.009). Forty-seven HIV-positive patients (79.7%) and 291 HIV-negative patients (89.8%) completed the equivalent dose of 68 Grays (Gy) external- beam radiation and high-dose-rate brachytherapy. (P =.03). Of the 333 patients who commenced concurrent chemotherapy, 26 HIV-positive patients (53.1%) and 212 HIV-negative patients (74.6%) completed ≥4 weekly cycles of platinum-based treatment. Follow-up was censured at 6 weeks. In models that included age, disease stage, HIV status, and treatment, a poor response at 6 weeks was associated only with stage IIIB disease (odds ratio, 2.39; 95% confidence interval, 1.45-3.96) and receiving an equivalent radiation dose in 2-Gy fractions of <68 Gy (OR, 3.14; 95% CI, 1.24-7.94). CONCLUSIONS: HIV-positive patients fared worse than HIV-negative patients because of later presentation and a decreased likelihood of completing treatment. The current findings emphasize the importance of completing irradiation therapy. Further studies will address the association of these variables with survival. Copyright © 2011 American Cancer Society.
dc.identifier.citationCancer
dc.identifier.citation118
dc.identifier.citation11
dc.identifier.citation2971
dc.identifier.citation2979
dc.identifier.issn0008543X
dc.identifier.otherdoi:10.1002/cncr.26639
dc.identifier.urihttp://hdl.handle.net/10019.1/21349
dc.subjectacquired immunodeficiency syndrome-defining malignancy
dc.subjectcervical cancer
dc.subjectchemoradiation
dc.subjecthuman immunodeficiency virus-positive
dc.subjectradiation
dc.titleCompletion of and early response to chemoradiation among human immunodeficiency virus (HIV)-positive and HIV-negative patients with locally advanced cervical carcinoma in South Africa
dc.typeArticle
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