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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Completion of and early response to chemoradiation among human immunodeficiency virus (HIV)-positive and HIV-negative patients with locally advanced cervical carcinoma in South Africa
Cancer, Volume 118, No. 11, Year 2012
Notification
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Description
BACKGROUND: Very few published studies have dealt with the management of locally advanced cervix carcinoma among human immunodeficiency virus (HIV)-positive patients. The objective of this study was to compare the clinical characteristics, radiation and chemotherapy treatments, and outcomes in a cohort of HIV-positive and HIV-negative women with cervical cancer. METHODS: The authors reviewed the charts of 59 HIV-positive patients and 324 HIV-negative patients who had stage IB1 to IIIB cervical carcinoma and who received radiation therapy. Demographic and clinical characteristics were compared at the time of diagnosis; and radiation doses, chemotherapy cycles, and responses were compared at the time of brachytherapy and at 6-week follow-up. Logistic regression models of response to treatment were developed. RESULTS: Forty-nine HIV-positive patients (88.1%) but only 213 HIV-negative patients (65.7%) presented with stage IIIB disease (P =.009). Forty-seven HIV-positive patients (79.7%) and 291 HIV-negative patients (89.8%) completed the equivalent dose of 68 Grays (Gy) external- beam radiation and high-dose-rate brachytherapy. (P =.03). Of the 333 patients who commenced concurrent chemotherapy, 26 HIV-positive patients (53.1%) and 212 HIV-negative patients (74.6%) completed ≥4 weekly cycles of platinum-based treatment. Follow-up was censured at 6 weeks. In models that included age, disease stage, HIV status, and treatment, a poor response at 6 weeks was associated only with stage IIIB disease (odds ratio, 2.39; 95% confidence interval, 1.45-3.96) and receiving an equivalent radiation dose in 2-Gy fractions of <68 Gy (OR, 3.14; 95% CI, 1.24-7.94). CONCLUSIONS: HIV-positive patients fared worse than HIV-negative patients because of later presentation and a decreased likelihood of completing treatment. The current findings emphasize the importance of completing irradiation therapy. Further studies will address the association of these variables with survival. Copyright © 2011 American Cancer Society.
Authors & Co-Authors
Simonds, Hannah M.
South Africa, Tygerberg
Tygerberg Hospital
Wright, Jason D.
United States, New York
Vagelos College of Physicians and Surgeons
United States, New York
Columbia University
Du Toit, Naomi
South Africa, Tygerberg
Tygerberg Hospital
Neugut, Alfred I.
United States, New York
Columbia University
United States, New York
Mailman School of Public Health
United States, New York
Vagelos College of Physicians and Surgeons
Jacobson, Judith S.
United States, New York
Columbia University
United States, New York
Mailman School of Public Health
Statistics
Citations: 52
Authors: 5
Affiliations: 4
Identifiers
Doi:
10.1002/cncr.26639
ISSN:
0008543X
e-ISSN:
10970142
Research Areas
Cancer
Infectious Diseases
Study Design
Cohort Study
Case-Control Study
Study Locations
South Africa
Participants Gender
Female