Combined modality therapy for HIV-infected patients with squamous cell carcinoma of the anus: Outcomes and toxicities

Invasive Anal Squamous-Cell Carcinoma in the HIV-Positive Patient: Outcome in the Era of Highly Active Antiretroviral Therapy

“…In the present study of 32 patients, which comprises the largest published series of HIV-positive patients with anal cancer treated with chemoradiotherapy, the local failure rate was only 16 percent, which is comparable to the report of the next largest series of HIV infected individuals by Edelman et al 18 who noted 2 of 15 patients (13.3 percent) with local persistence or relapse of invasive disease. These results suggest that HIV-positive patients with anal carcinoma may have similar locoregional control as their non-HIV counterparts, when similar treatment is delivered.…”

“…Similarly, Edelman et al 18 reported that seven of eight patients with high CD4 counts (>200 cells/μl) survived compared with four of seven patients with low CD4 counts. In our series, the worse overall survival in patients with unfavorable CD4 and viral load was a result of both a worse anal-cancer specific survival (at least partly related to larger tumor size at presentation in that group) and worse HIVspecific survival.…”

“…Patients with CD4 counts >200 cells/μl tend to have fewer hospitalizations, fewer treatment interruptions, decreased need for colostomy, and improved survival. [14][15][16][17][18] In patients with well-controlled HIV disease, rates of local control and overall survival are similar to those seen in patients with anal cancer who are HIV-negative. 19,20 In the present series, we report outcomes in the largest series of HIV-infected individuals undergoing treatment for SCC in the post-HAART era.…”

HIV-Associated Anal Dysplasia and Anal Carcinoma

“…In general, response rates and OS are equivalent to those of HIV-negative patients in the era of cART [65], as illustrated by a large retrospective cohort study (n = 1,884) of patients with anal cancer receiving CRT: Those patients who were HIV-positive (15%) had identical survival rates compared to non-infected individuals [66]. Other retrospective studies demonstrated similar complete response rates and OS, but inconsistent results on local tumor control [65,[67][68][69]. In several trials, an increased toxicity in HIV-infected individuals was observed [67,70], especially in those with CD4 cell counts below 200/μl [71].…”

“…Other retrospective studies demonstrated similar complete response rates and OS, but inconsistent results on local tumor control [65,[67][68][69]. In several trials, an increased toxicity in HIV-infected individuals was observed [67,70], especially in those with CD4 cell counts below 200/μl [71]. Furthermore, anal cancer patients with HIV infection are predominantly younger than their HIV-negative counterparts [16,33].…”