skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Concurrent Chemoradiotherapy With 5-Fluorouracil and Mitomycin C for Invasive Anal Carcinoma in Human Immunodeficiency Virus-Positive Patients Receiving Highly Active Antiretroviral Therapy

Abstract

Purpose: To report the clinical outcomes of chemoradiotherapy (CRT) for anal carcinoma in human immunodeficiency virus (HIV)-infected patients receiving highly active antiretroviral therapy. Patients and Methods: Between 1997 and 2008, 21 HIV-positive patients who were receiving highly active antiretroviral therapy were treated with CRT (50.4 Gy at 1.8 Gy/fraction plus a 5.4-10.8-Gy external boost; 5-fluorouracil, 1,000 mg/m{sup 2}, Days 1-4 and 29-32; and mitomycin C, 10 mg/m{sup 2}, Days 1 and 29). A retrospective analysis was performed with respect to the tumor response, local control, cancer-specific and overall survival, and toxicity. The immunologic parameters, including pre- and post-treatment CD4 count, viral load, and acquired immunodeficiency syndrome-specific morbidity was recorded during follow-up (median, 53 months; range, 10-99). Results: CRT could be completed in all 21 patients with a reduction in the chemotherapy dose and/or interruption of radiotherapy in 5 and 5 cases, respectively. Acute Grade 3 toxicity occurred in 8 (38%) of the 21 patients. A complete response was achieved in 17 patients (81%), and tumor persistence or early progression was noted in 4 (19%). Six patients (29%) died, 5 of cancer progression and 1 of treatment-related toxicity. The 5-year local control, cancer-specific, and overall survival rate was 59%, 75%, andmore » 67%, respectively. The median CD4 count significantly decreased from 347.5 cells/muL before CRT to 125 cells/muL 3-7 weeks after CRT completion (p <.001). In 6 (32%) of 19 patients, an increase of the HIV viral load was noted. Both parameters returned to the pretreatment values with additional follow-up. Conclusion: Our data have confirmed that in the highly active antiretroviral therapy era, HIV-related anal cancer can be treated with standard CRT without dose reductions. Close surveillance of the immunologic parameters is necessary.« less

Authors:
 [1]; ;  [1];  [2];  [1]
  1. Department of Radiation Oncology, Johann Wolfgang Goethe-University, Frankfurt/Main (Germany)
  2. HIV Treatment and Clinical Research Unit, Department of Internal Medicine II, Johann Wolfgang Goethe-University, Frankfurt/Main (Germany)
Publication Date:
OSTI Identifier:
21372208
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 76; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2009.03.060; PII: S0360-3016(09)00559-8; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; AIDS VIRUS; CARCINOMAS; CHEMOTHERAPY; COMBINED THERAPY; FLUOROURACILS; INTESTINES; MITOMYCIN; ORIFICES; RADIOTHERAPY; TOXICITY; ANTIBIOTICS; ANTI-INFECTIVE AGENTS; ANTIMETABOLITES; ANTIMITOTIC DRUGS; ANTINEOPLASTIC DRUGS; AZINES; BODY; DIGESTIVE SYSTEM; DISEASES; DRUGS; GASTROINTESTINAL TRACT; HETEROCYCLIC COMPOUNDS; HYDROXY COMPOUNDS; MEDICINE; MICROORGANISMS; NEOPLASMS; NUCLEAR MEDICINE; OPENINGS; ORGANIC COMPOUNDS; ORGANIC FLUORINE COMPOUNDS; ORGANIC HALOGEN COMPOUNDS; ORGANIC NITROGEN COMPOUNDS; ORGANS; PARASITES; PYRIMIDINES; RADIOLOGY; THERAPY; URACILS; VIRUSES

Citation Formats

Fraunholz, Ingeborg, E-mail: inge.fraunholz@kgu.d, Weiss, Christian, Eberlein, Klaus, Haberl, Annette, and Roedel, Claus. Concurrent Chemoradiotherapy With 5-Fluorouracil and Mitomycin C for Invasive Anal Carcinoma in Human Immunodeficiency Virus-Positive Patients Receiving Highly Active Antiretroviral Therapy. United States: N. p., 2010. Web. doi:10.1016/j.ijrobp.2009.03.060.
Fraunholz, Ingeborg, E-mail: inge.fraunholz@kgu.d, Weiss, Christian, Eberlein, Klaus, Haberl, Annette, & Roedel, Claus. Concurrent Chemoradiotherapy With 5-Fluorouracil and Mitomycin C for Invasive Anal Carcinoma in Human Immunodeficiency Virus-Positive Patients Receiving Highly Active Antiretroviral Therapy. United States. doi:10.1016/j.ijrobp.2009.03.060.
Fraunholz, Ingeborg, E-mail: inge.fraunholz@kgu.d, Weiss, Christian, Eberlein, Klaus, Haberl, Annette, and Roedel, Claus. Thu . "Concurrent Chemoradiotherapy With 5-Fluorouracil and Mitomycin C for Invasive Anal Carcinoma in Human Immunodeficiency Virus-Positive Patients Receiving Highly Active Antiretroviral Therapy". United States. doi:10.1016/j.ijrobp.2009.03.060.
@article{osti_21372208,
title = {Concurrent Chemoradiotherapy With 5-Fluorouracil and Mitomycin C for Invasive Anal Carcinoma in Human Immunodeficiency Virus-Positive Patients Receiving Highly Active Antiretroviral Therapy},
author = {Fraunholz, Ingeborg, E-mail: inge.fraunholz@kgu.d and Weiss, Christian and Eberlein, Klaus and Haberl, Annette and Roedel, Claus},
abstractNote = {Purpose: To report the clinical outcomes of chemoradiotherapy (CRT) for anal carcinoma in human immunodeficiency virus (HIV)-infected patients receiving highly active antiretroviral therapy. Patients and Methods: Between 1997 and 2008, 21 HIV-positive patients who were receiving highly active antiretroviral therapy were treated with CRT (50.4 Gy at 1.8 Gy/fraction plus a 5.4-10.8-Gy external boost; 5-fluorouracil, 1,000 mg/m{sup 2}, Days 1-4 and 29-32; and mitomycin C, 10 mg/m{sup 2}, Days 1 and 29). A retrospective analysis was performed with respect to the tumor response, local control, cancer-specific and overall survival, and toxicity. The immunologic parameters, including pre- and post-treatment CD4 count, viral load, and acquired immunodeficiency syndrome-specific morbidity was recorded during follow-up (median, 53 months; range, 10-99). Results: CRT could be completed in all 21 patients with a reduction in the chemotherapy dose and/or interruption of radiotherapy in 5 and 5 cases, respectively. Acute Grade 3 toxicity occurred in 8 (38%) of the 21 patients. A complete response was achieved in 17 patients (81%), and tumor persistence or early progression was noted in 4 (19%). Six patients (29%) died, 5 of cancer progression and 1 of treatment-related toxicity. The 5-year local control, cancer-specific, and overall survival rate was 59%, 75%, and 67%, respectively. The median CD4 count significantly decreased from 347.5 cells/muL before CRT to 125 cells/muL 3-7 weeks after CRT completion (p <.001). In 6 (32%) of 19 patients, an increase of the HIV viral load was noted. Both parameters returned to the pretreatment values with additional follow-up. Conclusion: Our data have confirmed that in the highly active antiretroviral therapy era, HIV-related anal cancer can be treated with standard CRT without dose reductions. Close surveillance of the immunologic parameters is necessary.},
doi = {10.1016/j.ijrobp.2009.03.060},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 76,
place = {United States},
year = {2010},
month = {4}
}