Toxicity of Head-and-Neck Radiation Therapy in Human Immunodeficiency Virus–Positive Patients

• Published in: International journal of radiation oncology, biology, physics Vol. 77; no. 5; pp. 1375 - 1379
• Main Authors: Sanfilippo, Nicholas J., M.D, Mitchell, James, M.D, Grew, David, M.P.H., M.D, DeLacure, Mark, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-08-2010; Elsevier
• Subjects: Acute toxicity; Adult; Aged; AIDS VIRUS; Antiretroviral Therapy, Highly Active; BEAMS; Biological and medical sciences; BODY; Carcinoma, Squamous Cell - complications; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; CARCINOMAS; DISEASE INCIDENCE; DISEASES; ELECTRON BEAMS; Female; HEAD; Head and neck cancer; Head and Neck Neoplasms - complications; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - radiotherapy; Hematology, Oncology and Palliative Medicine; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Seropositivity - complications; HIV Seropositivity - drug therapy; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; LEPTON BEAMS; Male; Medical sciences; MEDICINE; MICROORGANISMS; Middle Aged; Morbidity; Mucositis; NECK; NEOPLASMS; NUCLEAR MEDICINE; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; PARASITES; Parotitis - complications; Parotitis - radiotherapy; PARTICLE BEAMS; PHOTON BEAMS; Radiation Injuries - pathology; Radiation Tolerance; Radiation toxicity; RADIOLOGY; RADIOLOGY AND NUCLEAR MEDICINE; RADIOTHERAPY; Radiotherapy Dosage; THERAPY; TOXICITY; Tumors; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; VIRUSES; Head and neck cancer; Mucositis; HIV; Radiation toxicity; Morbidity; Immunopathology; Toxicity; AIDS; Malignant tumor; Radiotherapy; Immune deficiency; Infection; Treatment; Viral disease; Head and neck; ENT disease; Cancer
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/j.ijrobp.2009.06.087

Purpose To examine the acute morbidity of high dose head and neck RT and CRT in patients with infected with HIV. Methods and Materials All HIV-positive patients who underwent radiation therapy for head and neck cancer in our department between 2004 and 2008 were reviewed. Treatment related data were examined. All treatments were delivered with megavoltage photon beams or electron beams. Patients were evaluated by an attending radiation oncologist for toxicity and response on a weekly basis during therapy and monthly after treatment in a multidisciplinary clinic. Acute toxicities were recorded using the Radiation Therapy and Oncology Group (RTOG) common toxicity criteria. Response to treatment was based on both physical exam as well as post-treatment imaging as indicated. Results Thirteen patients who underwent RT with a diagnosis of HIV were identified. Median age was 53 years and median follow-up was 22 months. Twelve had squamous cell carcinoma and one had lymphoproliferative parotiditis. Median radiation dose was 66.4 Gy and median duration of treatment was 51 days. The median number of scheduled radiotherapy days missed was zero (range 0 to 7). One patient (8%) developed Grade 4 confluent moist desquamation. Eight patients (61%) developed Grade 3 toxicity. Conclusion Based on our results, HIV-positive individuals appear to tolerate treatment for head and neck cancer, with toxicity similar to that in HIV-negative individuals.