HIV 感染对乳腺癌手术、化疗和放疗管理的影响。一项前瞻性队列研究。

The effect of HIV infection on the surgical, chemo- and radiotherapy management of breast cancer. A prospective cohort study.

机构信息

Department of Surgery, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa.

出版信息

Int J Surg. 2016 Oct;34:109-115. doi: 10.1016/j.ijsu.2016.08.520. Epub 2016 Aug 26.

DOI:10.1016/j.ijsu.2016.08.520

PMID:27573692

Abstract

INTRODUCTION

Breast cancer is the most common cancer of women in the world. Twenty-five percent of people living with the human immunodeficiency virus (HIV) reside in South Africa. The coincidence of breast cancer and HIV infection is therefore common in South Africa. There is a perception that systemic and local surgical complications are more common in HIV-infected patients, and that these patients tolerate chemo- and radiotherapy poorly.

AIM

The aim of the study was to determine the effect of HIV infection on the management of breast cancer by comparing HIV-infected to -noninfected patients. The outcomes of surgery and adjuvant/neoadjuvant therapy were examined in these groups.

METHOD

The study was performed at the Steve Biko Academic Hospital, Pretoria, South Africa, during 2009-2014. Patients scheduled for surgery for breast cancer were recruited prospectively and their HIV status was determined. All patients were managed according to standard guidelines for breast cancer. Patients were followed up for 30 days and local and systemic surgical complications documented. Completion or non-completion of courses of chemo- and radiotherapy, and reasons for non-completion were documented. HIV-infected and -noninfected patients respectively were grouped, and compared statistically.

RESULTS

One hundred and sixty patients (31 HIV-infected) were included. The frequency of surgical complications did not differ significantly between HIV-noninfected and infected patients (p = 0.08), more occurring in the HIV-noninfected patients. The risk ratio of HIV infection for surgical complications was 0.20 and the odds ratio 0.23. The completion of courses of chemo- and radiotherapy did not differ between the HIV-infected and -noninfected patients. Twenty-five of 27 HIV-infected patients (93%) and 100 of 113 HIV-noninfected patients (94%) completed their courses of chemotherapy (p = 0.68). Twelve of 14 HIV-infected patients (86%) and 40 of 41 HIV-noninfected patients (98%) completed their courses of radiotherapy (p = 0.16).

CONCLUSION

These results suggest that HIV-infected patients with breast cancer do not experience more treatment-related complications and can be treated according to standard guidelines.

摘要

引言

乳腺癌是全世界女性最常见的癌症。全球 25%的艾滋病毒（HIV）感染者居住在南非。因此，南非的乳腺癌和 HIV 感染同时发生的情况很常见。人们认为 HIV 感染患者的全身和局部手术并发症更为常见，且这些患者对化疗和放疗的耐受性较差。

目的

本研究旨在通过比较 HIV 感染者和非感染者，确定 HIV 感染对乳腺癌治疗的影响。研究检查了这两组患者的手术和辅助/新辅助治疗结果。

方法

本研究于 2009 年至 2014 年在南非比勒陀利亚史蒂夫·比科学术医院进行。前瞻性招募了计划接受乳腺癌手术的患者，并确定了他们的 HIV 状态。所有患者均按照乳腺癌标准指南进行管理。对患者进行了 30 天的随访，并记录了局部和全身手术并发症。记录了化疗和放疗疗程的完成或未完成情况，以及未完成的原因。将 HIV 感染者和非感染者分别分组，并进行统计学比较。

结果

共纳入 160 例患者（31 例 HIV 感染者）。HIV 阴性和阳性患者的手术并发症发生率无显著差异（p=0.08），HIV 阴性患者的手术并发症发生率更高。HIV 感染发生手术并发症的风险比为 0.20，优势比为 0.23。HIV 感染与非感染患者的化疗和放疗疗程完成情况无差异。27 例 HIV 感染者中有 25 例（93%）和 113 例 HIV 阴性患者中有 100 例（94%）完成了化疗疗程（p=0.68）。14 例 HIV 感染者中有 12 例（86%）和 41 例 HIV 阴性患者中有 40 例（98%）完成了放疗疗程（p=0.16）。