Five-year overall survival following chemoradiation among HIV-positive and HIV-negative patients with locally advanced cervical carcinoma in a South African cohort

Simonds, Hannah; Botha, Matthys H.; Neugut, Alfred I.; Merwe, Frederick H van der; Jacobson, Judith S.

doi:10.1016/j.ygyno.2018.08.038

Cited by 24 publications

(41 citation statements)

References 15 publications

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“…The radiation doses here were much lower than guideline-concordant treatment and the concurrenct chemotherapy is not enough. The 3-year OS survival rates for LCB group and SIB group in our study were 51.9% and 66.7%, which seems not inferior to those receiving standard concurrent chemoradiotherapy previously ( Supplementary Table 4) (7,10,13). Although the difference is not signi cant, the 3-year OS rate is in SIB group is better than LCB group.…”

Section: Discussionmentioning

confidence: 42%

“…Standard treatments for this set of patients have not been de ned, the management of cervical cancer in HIV-infected women were based on best practice for HIV-negative women, while seeking to optimize combination antiretroviral therapy (ART) (6). Some found the tolerance for chemoradiation was lower in HIV-infected patients (7,8), while others found the majority of these patients can complete standard concomitant chemoradiotherapy used in HIVuninfected women with comparable tolerability (9). Some studies showed HIV-infected women were at increased risk of relapses or a shortened life expectancy (7,10,11).…”

Section: Introductionmentioning

confidence: 99%

“…Some found the tolerance for chemoradiation was lower in HIV-infected patients (7,8), while others found the majority of these patients can complete standard concomitant chemoradiotherapy used in HIVuninfected women with comparable tolerability (9). Some studies showed HIV-infected women were at increased risk of relapses or a shortened life expectancy (7,10,11). Others found HIV infection did not affect survival (12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of survival outcomes by different treatments for HIV-infected cervical cancer: a real-world study in a single center in China

Zhang¹,

Jiang²,

Li³

et al. 2020

Preprint

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Background: Information on HIV-infected cervical cancer is very limited in China. The current study investigated long-term follow-up results of HIV-infected cervical cancer patients treated by different methods from an area in southwestern China in which HIV and cervical cancer are endemic.Methods: All HIV-infected cervical cancer patients registered in Yunnan Cancer Hospital from January 2015 to December 2017 were retrospective reviewed. Overall survival (OS) was the primary end-point.Results: A total of 47 patients entered into the study. 7 patients underwent radical surgery. 24 patients received radiotherapy with high palliative intent, including intensity modulated radiotherapy (IMRT)/volume modulated arc therapy (VMAT)/helical tomotherapy (TOMO) with simultaneous integrated boost (SIB) (SIB; n=15), IMRT/VMAT to the pelvis followed by late course boost (LCB) (LCB; n=9) to the gross tumor volume (GTV). 3 patients received simple external beam radiotherapy to the pelvis (EBRT) (SEBRT; n=3). 13 patients gave up anti-tumor therapy at the initial diagnosis.The 3-year OS for patients who received surgery, LCB, SIB, SEBRT, no anti-tumor treatment were 100%, 51.9%, 66.7%, 0%, and 0%. All of the deaths were attributed to cancer. The prognosis of HIV-infected cervical cancer patients was closely related to the treatment methods (p＜0.05).Conclusions: LCB and SIB are effective and safe modality for treatment of HIV-infected cervical cancer in a limited resource setting.

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Section: Discussionmentioning

confidence: 42%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of survival outcomes by different treatments for HIV-infected cervical cancer: a real-world study in a single center in China

Zhang¹,

Jiang²,

Li³

et al. 2020

Preprint

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“…21 In a large prospective study, Simonds et al recently reported differences in survival between HIV-positive and HIV-negative patients with HIV-positive patients having a poorer survival. 8 HIV status did not, however, confer any prognostic significance in this cohort on multivariate analysis, p = 0.393.…”

Section: Discussionmentioning

confidence: 58%

“…5,6 HIV infection is also associated with poorer survival in countries with a high incidence of HIV. [7][8][9] Venous thromboembolism has been reported as a poor prognostic factor in several gynaecological malignancies including cervical cancer. 10 The reported incidence of venous thromboembolism in patients with cervical cancer is between 3.3% and 15.7%.…”

Section: Introductionmentioning

confidence: 99%

The impact of venous thromboembolism on the outcomes of patients with cervical carcinoma, a retrospective analysis at a single institution

Shiba

Sharma

2019

Southern African Journal of Gynaecological Oncology

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Background: Venous thromboembolism (VTE) is a frequent cause of morbidity in patients with cervical cancer. The aim of this study was to investigate the survival outcomes of patients with cervical cancer and VTE in a South African population. Material and methods: The records of 47 cervical cancer patients with a concomitant diagnosis of a deep vein thrombosis (DVT)/ VTE who were admitted to the radiation oncology ward at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in 2015 and 2016 were identified and analysed retrospectively. Data collected included the age, stage, human immunodeficiency virus (HIV) status and details of diagnosis of VTE and the treatment received. The survival of patients from diagnosis of VTE and the two-year overall survival (OS) rate was calculated using the Kaplan-Meier method. Univariate and multivariate analyses of factors influencing survival were performed on selected clinical variables. Results: The majority of patients (60%) had stage IIIB cervical cancer; 60% of patients were HIV-positive. The median survival of patients from the time of diagnosis of VTE was 2.7 months (interquartile range [IQR]: 0.97-6.93 months) and the 12-month survival from diagnosis of VTE for this cohort was 17%. Once a VTE was diagnosed the survival becomes poor irrespective of age, stage or HIV status. The two-year OS of this cohort from date of diagnosis of cancer was 29.8%. Patients who were diagnosed with a VTE before or during radiotherapy had a significantly lower OS than that of patients who were diagnosed with a VTE after radiotherapy (12.5% versus 38.7%), p = 0.004. Conclusion: The diagnosis of VTE is a poor prognostic factor in patients with locally advanced cervical cancer.

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Significance of HIV status in cervical cancer patients receiving curative chemoradiation therapy, definitive radiation alone, or palliative radiation in Botswana

Meghani,

Puri,

Bazzett‐Matabele

et al. 2024

Cancer

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BACKGROUNDCervical cancer associated with human papillomavirus has the highest cancer incidence and mortality for women in Botswana because of a high HIV prevalence and limited screening. This study investigates the significance of HIV on the overall survival (OS) of patients with locally advanced cervical cancer by various treatment categories (curative chemoradiation, definitive radiation [RT] alone, or palliative RT alone).METHODSThis study included patients diagnosed with cervical cancer between 2013 and 2020, prospectively enrolled in the Botswana Prospective Cancer Cohort. OS based on HIV status and completion of planned treatment regimen was estimated by the Kaplan–Meier method. Comparisons of 2‐year OS by HIV status was performed by the log‐rank test, univariate and multivariable Cox analyses adjusting for cancer stage, RT dose, number of chemotherapy cycles, and baseline hemoglobin levels.RESULTSOf 1131 patients diagnosed with stage IB‐IVB cervical cancer, 69.8% were women living with HIV (n = 789). For patients receiving curative chemoradiation, HIV status was not significantly associated with OS in unadjusted (p = .987) and adjusted (p = .578) analyses. For RT only treatment and definitive (high‐dose) RT alone, HIV status was significantly associated with OS in unadjusted analysis (HR = 1.77, p = .002; HR = 1.95, p = .014), but not in adjusted analysis (p = .227, p = .73). For patients receiving palliative (low‐dose) RT, HIV status was not associated with OS in unadjusted (p = .835) or adjusted analysis (p = .359).CONCLUSIONSIn Botswana, a resource‐limited setting, HIV status had no significant effect on 2‐year OS in patients with cervical cancer with well‐managed HIV receiving chemoradiation, RT alone, or palliative RT. This demonstrates that patients living with HIV receiving antiretroviral treatment can receive clinically appropriate treatment with no evidence that HIV may lead to poorer outcomes.

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Five-year overall survival following chemoradiation among HIV-positive and HIV-negative patients with locally advanced cervical carcinoma in a South African cohort

Cited by 24 publications

References 15 publications

Comparison of survival outcomes by different treatments for HIV-infected cervical cancer: a real-world study in a single center in China

Comparison of survival outcomes by different treatments for HIV-infected cervical cancer: a real-world study in a single center in China

The impact of venous thromboembolism on the outcomes of patients with cervical carcinoma, a retrospective analysis at a single institution

Significance of HIV status in cervical cancer patients receiving curative chemoradiation therapy, definitive radiation alone, or palliative radiation in Botswana

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