HIV-positive head and neck cancer patients respond well to radiation therapy treatments and experience toxicity rates similar to HIV-negative patients, according to a study in the International Journal of Radiation Oncology, Biology, Physics (January 2011, Vol. 79:1, pp. 60-64).
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 resulted in 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 new 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% and 92%, respectively. Grade 3 or higher toxicity was reported by 58% of patients, but this did not appear worse than the standard rate seen in HIV-negative patients.
The researchers did note that 75% of patients studied were receiving HAART 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.
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