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

Int J Radiat Oncol Biol Phys. 2010 Aug 1;77(5):1375-9. doi: 10.1016/j.ijrobp.2009.06.087. Epub 2010 Jan 25.

Abstract

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.

MeSH terms

  • Adult
  • Aged
  • Antiretroviral Therapy, Highly Active
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Seropositivity / complications
  • HIV Seropositivity / drug therapy
  • Head and Neck Neoplasms / complications
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Male
  • Middle Aged
  • Parotitis / complications
  • Parotitis / radiotherapy*
  • Radiation Injuries / pathology
  • Radiation Tolerance*
  • Radiotherapy Dosage