Impact of Human Immunodeficiency Virus Infection on Survival and Acute Toxicities From Chemoradiation Therapy for Cervical Cancer Patients in a Limited-Resource Setting
Impact of Human Immunodeficiency Virus Infection on Survival and Acute Toxicities From Chemoradiation Therapy for Cervical Cancer Patients in a Limited-Resource Setting
复制标题
DOI：
10.1016/j.ijrobp.2018.01.067
复制
发表时间：
2018-05-01
影响因子：
7
通讯作者：
Lin, Lilie L.
中科院分区：
文献类型：
--
作者：
Grover, Surbhi;Bvochora-Nsingo, Memory;Lin, Lilie L.
目的：前瞻性比较在有限资源环境中启动根治性放化疗（CRT）的人类免疫缺陷病毒（HIV）感染与未感染HIV的宫颈癌患者的生存率。方法和材料：在博茨瓦纳，有或无HIV感染的局部晚期宫颈癌患者启动根治性CRT，从2013年7月至2015年1月参加了一项前瞻性、观察性、队列研究。在研究期间接受宫颈癌治疗的182名妇女中，有143名妇女开始接受治疗性CRT。85%的参与者（143人中的122人）患有II/III期宫颈癌，67%（143人中的96人）感染了艾滋病毒。所有感染艾滋病毒的患者在开始治疗宫颈癌时都在接受抗逆转录病毒治疗。我们发现HIV感染和未感染HIV的女性之间的毒性没有差异。HIV感染妇女的2年总生存率（OS）为65%（95%置信区间[CI] 54%-74%），HIV未感染妇女为66%（95% CI 49%-79%）（P = 0.70）。多变量分析显示，与2年OS较好相关的因素包括基线血红蛋白> 10 g/dL（风险比[HR] 0.37，95% CI 0.190.72，P = .003），总放射剂量>= 75戈伊（HR 0.52，95% CI 0.27-0.97，P = .04）和年龄
Purpose: To prospectively compare survival between human immunodeficiency virus (HIV)-infected versus HIV-uninfected cervical cancer patients who initiated curative chemoradiation therapy (CRT) in a limited-resource setting.Methods and Materials: Women with locally advanced cervical cancer with or without HIV infection initiating radical CRT in Botswana were enrolled in a prospective, observational, cohort study from July 2013 through January 2015.Results: Of 182 women treated for cervical cancer during the study period, 143 women initiating curative CRT were included in the study. Eighty-five percent of the participants (122 of 143) had stage II/III cervical cancer, and 67% (96 of 143) were HIV-infected. All HIV-infected patients were receiving antiretroviral therapy (ART) at the time of curative cervical cancer treatment initiation. We found no difference in toxicities between HIV-infected and HIV-uninfected women. The 2-year overall survival (OS) rates were 65% for HIV-infected women (95% confidence interval [CI] 54%-74%) and 66% for HIV-uninfected women (95% CI 49%-79%) (P = .70). Factors associated with better 2-year OS on multivariate analyses included baseline hemoglobin > 10 g/dL (hazard ratio [HR] 0.37, 95% CI 0.190.72, P = .003), total radiation dose >= 75 Gy (HR 0.52, 95% CI 0.27-0.97, P = .04), and age