HIV status may affect outcomes after definitive
chemoradiotherapy for anal cancer.
Here, we report a large series in the highly active
antiretroviral therapy era comparing outcomes between HIV-positive and
HIV-negative patients with anal cancer.
This was a retrospective chart review.
The study was conducted at an outpatient oncology clinic at
large academic center.
A total of 107 patients were reviewed, 39 HIV positive and
68 HIV negative. All of the patients underwent definitive chemoradiation for
anal cancer.
Data on patient characteristics, treatment, toxicity, and
outcomes were collected. Overall survival, colostomy-free survival, local
recurrence-free survival, and distant metastasis-free survival were analyzed.
Median follow-up was 15 months. HIV-positive patients were
younger (median, 52 vs 64 years; p < 0.001) and predominantly men (82% men
vs 49% men; p = 0.001). There were no significant differences in T, N, or stage
groups. HIV-positive patients had a significantly longer duration from biopsy
to start of chemoradiation (mean number of days, 82 vs 54; p = 0.042). There
were no differences in rates of acute toxicities including diarrhea, fatigue,
or dermatitis. HIV-positive patients had significantly higher rates of
hospitalization (33% vs 15%; p = 0.024). The 3-year overall survival rate was
42% in HIV-positive and 76% in HIV-negative patients (p = 0.037; HR, 2.335 (95%
CI, 1.032-5.283)). Three-year colostomy-free survival was 67% in HIV-positive
and 88% in HIV-negative patients (p = 0.036; HR, 3.231 (95% CI, 1.014-10.299)).
Differences in overall survival rates were not significant on multivariate
analysis.
This study was limited by its retrospective design and small
patient numbers.
In this cohort, HIV-positive patients had significantly
worse overall and colostomy-free survival rates than HIV-negative patients.
However, differences in survival were not significant on multivariate analysis.
Additional studies are necessary to establish the etiology of this difference.
Purchase full article at: http://goo.gl/0M2kNK
By:
- 1 Department of Radiation Oncology, New York University Langone Medical Center, New York, New York 2 Division of Hematology and Oncology, New York University Langone Medical Center, New York, New York 3 Department of Surgery, New York University Langone Medical Center, New York, New York.
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