HIV-positive head and neck cancer patients benefit from radiation therapy
Fairfax, Va., January 18, 2011 - HIV-positive head and neck cancer patients respond well to radiation
therapy treatments and experience similar toxicity rates as non-HIV-positive patients, despite prior reports to the contrary,
according to a study in the January issue of the International Journal of Radiation Oncology.Biology.Physics, an official
journal of the American Society for Radiation Oncology (ASTRO).
Patients with HIV have a significantly higher risk of developing some types of cancers; however, since the
use of highly active antiretroviral therapy (HAART) began in the mid-1990s, the instances of AIDS-related cancer have greatly
decreased. This has alternately caused a higher incidence of these patients developing non-AIDS-related cancers, including
those originating from the head and neck.
Radiation therapy constitutes a current standard treatment for head and neck cancer, but there has been
very little investigation into how radiation therapy affects HIV-positive patients. Traditionally, aggressive treatment such as
radiation therapy has been used sparingly in this population due to concerns regarding acute and late complications. This newly
presented research sought to determine the feasibility of radiation therapy and the likelihood of cure for HIV-positive
patients with head and neck cancer.
The three-year estimates of overall survival and local-regional control were 78 percent and 92 percent,
respectively. Grade 3+ toxicity was reported by 58 percent of patients, but this did not appear worse than the standard rate seen
in HIV-negative patients.
The researchers did note that 75 percent of patients studied were receiving HAART therapy at the time of treatment. Also, all patients
underwent dental prophylaxis and gastrostomy tube placement before beginning therapy, which may have played a role in the toxicity
levels remaining comparable to HIV-negative patients. Dental prophylaxis, gastrostomy tubes, and monitoring of CD4 counts are
recommended in these patients to minimize treatment complications.
"It is clear that HIV-positive patients tolerated primary radiation therapy for head-and-neck cancer without excessive toxicity or exaggerated
tissue reactions," Allen Chen, M.D., senior author of the study and training program director at the University of California Davis Cancer
Center in Sacramento, California, said. "With HIV-positive patients living longer than ever before and therefore developing cancers
unrelated to their HIV, these studies are important to ensure that we are treating these patients for cancer in a way that
provides them with the best possible outcomes."
Study: PRIMARY RADIATION THERAPY FOR HEAD-AND-NECK CANCER IN THE SETTING
ASTRO is the largest radiation oncology society in the world, with more than 10,000 members who specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, biology and physics, the Society is dedicated to improving patient care through education, clinical practice, advancement of science and advocacy. For more information on radiation therapy, visit www.rtanswers.org. To learn more about ASTRO, visit www.astro.org.
American Society for Radiation Oncology
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Reproduced with permission - "American Society for Radiation Oncology"
American Society for Radiation Oncology (ASTRO)