Division of Hematology and Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI 48201, USA.
Am J Clin Oncol. 2011 Apr;34(2):135-9. doi: 10.1097/COC.0b013e3181dbb710.
Human immunodeficiency virus (HIV)-infected patients are at increased risk for squamous cell carcinoma of the anal canal (SCCA) and the incidence of SCCA has increased in the era of highly active antiretroviral therapy. The outcome of SCCA in HIV-positive patients has not been evaluated in prospective trials and the published literature is limited to retrospective case series. The aim of this study is to describe the treatment, toxicity, and overall survival (OS) in patients with and without HIV infection.
We performed a retrospective chart review of all patients treated for invasive SCCA at Karmanos Cancer Institute, Wayne State University from 1991 to 2007 and collected data regarding HIV status, demographics, stage at diagnosis, treatment, response to treatment, toxicity, and survival.
Forty-five patients with SCCA were identified, of whom 13 were HIV-positive and 32 were HIV-negative. HIV-positive patients were younger (median age, 45 vs. 57 years) and had a higher frequency of men (89% vs. 37%). Patients were balanced for presenting stage at diagnosis and rates of local recurrence were found to be similar between the 2 groups. HIV-positive patients were less likely to receive full dose chemoradiotherapy. Except for dermatitis, the incidence of grade 3 to 4 toxicities was similar in both groups. Median OS was 33.5 months for HIV-positive patients and 71.8 months for HIV-negative patients. Although limited by the small size of the study, the OS was not statistically significantly different by HIV status (P = 0.787).
Although the HIV-positive patients received lower dose chemoradiotherapy, no major difference in local control or overall survival was observed.
感染人类免疫缺陷病毒 (HIV) 的患者患肛门管鳞癌 (SCCA) 的风险增加，并且在高效抗逆转录病毒治疗时代，SCCA 的发病率有所增加。HIV 阳性患者的 SCCA 预后尚未在前瞻性试验中进行评估，并且已发表的文献仅限于回顾性病例系列。本研究的目的是描述 HIV 阳性和阴性患者的治疗、毒性和总生存 (OS)。
我们对 1991 年至 2007 年在 Karmanos 癌症研究所、韦恩州立大学接受侵袭性 SCCA 治疗的所有患者进行了回顾性图表审查，并收集了有关 HIV 状态、人口统计学、诊断时的分期、治疗、治疗反应、毒性和生存的数据。
确定了 45 例 SCCA 患者，其中 13 例为 HIV 阳性，32 例为 HIV 阴性。HIV 阳性患者年龄较小（中位年龄，45 岁 vs. 57 岁），男性比例较高（89% vs. 37%）。两组患者在诊断时的分期相似，局部复发率相似。HIV 阳性患者接受全剂量放化疗的可能性较低。除了皮炎，两组的 3 至 4 级毒性发生率相似。HIV 阳性患者的中位 OS 为 33.5 个月，HIV 阴性患者的中位 OS 为 71.8 个月。尽管受到研究规模较小的限制，但 HIV 状态对 OS 无统计学显著差异（P = 0.787）。
尽管 HIV 阳性患者接受了较低剂量的放化疗，但在局部控制或总生存方面没有观察到明显差异。
