HIV and Early Treatment Outcomes Among Women With Cervical Cancer Treated With Concurrent Chemoradiation in Tanzania.
HIV and Early Treatment Outcomes Among Women With Cervical Cancer Treated With Concurrent Chemoradiation in Tanzania.
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DOI：
10.1200/go.22.00441
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发表时间：
2023-09
影响因子：
4.5
通讯作者：
Mwaiselage, Julius
中科院分区：
文献类型：
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作者：
Mrema, Alita Steven;Ngoma, Mamsau;Josiah, Chacha;Lugina, Emmanuel;Mvungi, Nanzoke;Paul, Magreth;Mkuchika, Evelyne;Nundu, Emmanuel;Iddy, Salama Khamisi;Rugengamanzi, Eulade;Vuhahula, Yokobeth Mtambo;Kiwanga, Faraja Christopher;Wood, Charles;Mwaiselage, Julius
宫颈癌（CC）是坦桑尼亚的主要恶性肿瘤。低收入国家面临着艾滋病毒和CC的双重流行。本研究旨在调查在坦桑尼亚高活性抗逆转录病毒治疗时代，艾滋病毒和癌症诊断阶段如何影响同时接受放化疗的CC妇女的早期治疗结果。这是一项前瞻性队列研究，研究对象为2019年11月至2020年1月在Ocean Road癌症研究所新诊断为CC的患者。治疗后3个月使用RECIST评估肿瘤缓解。根据超声和盆腔检查结果，将肿瘤缓解分类为完全或部分缓解。单变量和多变量逻辑回归解释了几个协变量（年龄、分期、艾滋病毒状态、2戈伊分次的等效剂量、化疗周期和治疗时间）和治疗反应之间的关系。基线时共有102例CC患者纳入本研究。在调整其他协变量后，只有在56天内完成治疗（比值比[OR]，9.23; 95%CI，1.53至55.85; P = 0.016）和接受至少3个周期的顺铂（OR，5.6; 95%CI，1.47至21.34; P = 0.012）与肿瘤完全缓解显著相关。HIV状态与肿瘤完全缓解无显著相关性（OR，1.534; 95%CI，0.424 - 5.545; P = 0.5144）。早期治疗反应与艾滋病毒状况无关。随着抗逆转录病毒疗法的广泛覆盖，艾滋病毒感染者可以接受根治性治疗，并与艾滋病毒阴性患者获得相同的早期结果。
Cervical cancer (CC) is the leading malignancy in Tanzania. Low-income countries are faced with double epidemics of HIV and CC. This study aimed to investigate how HIV and cancer stage at diagnosis affect early treatment outcomes among women with CC treated with concurrent chemoradiation in Tanzania in the highly active antiretroviral therapy era. This was a prospective cohort study of patients newly diagnosed with CC at the Ocean Road Cancer Institute from November 2019 to January 2020. The tumor response was assessed using RECIST 3 months post-treatment. The tumor response was categorized as a complete or partial response according to the ultrasound and pelvic examination findings. The univariate and multivariate logistic regression explained the relationship between several covariates (age, stage, HIV status, equivalent dose in 2 Gy fractions, chemotherapy cycles, and treatment time) and treatment response. A total of 102 patients with CC were included in this study at baseline. After adjusting for other covariates, only completion of treatment within 56 days (odds ratio [OR], 9.23; 95% CI, 1.53 to 55.85; P = .016) and receiving at least three cycles of cisplatin (OR, 5.6; 95% CI, 1.47 to 21.34; P = .012) were significantly associated with complete tumor response. HIV status was not significantly associated with complete tumor response (OR, 1.534; 95% CI, 0.424 to 5.545; P = .5144). Early treatment response was independent of HIV status. With wide coverage of anitretroviral therapy, patients with HIV can receive radical treatment and have the same early outcomes as their HIV-negative counterparts.