Takahashi Satoshi, Okuma Yusuke, Watanabe Kageaki, Hosomi Yukio, Imamura Akifumi, Okamura Tatsuru, Gemma Akihiko
Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-8677, Japan.
Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo 113-8602, Japan.
Mol Clin Oncol. 2017 May;6(5):765-769. doi: 10.3892/mco.2017.1214. Epub 2017 Apr 6.
The advent of antiretroviral therapy has changed the disease spectrum constitution among patients living with human immunodeficiency virus (HIV), while the incidence of death due to non-AIDS-defining cancers, particularly lung cancer, continues to increase in the USA and Europe. However, the availability of detailed reports of the clinical characteristics of lung cancer among Asian populations is limited. The present study retrospectively analyzed the clinical characteristics, treatment regimens and outcomes of lung cancer patients with HIV who were treated in a single institution between 1988 and 2013. Of the 20 lung cancer patients living with HIV included in this study, 90% were diagnosed since 1996 in the post-antiretroviral era. The median CD4 cell count was 373.5/µl, whereas 65% of the patients were diagnosed with adenocarcinoma and 30% with squamous cell carcinoma. Epidermal growth factor receptor mutations were detected in 3 (27%) of the 11 specimens for which data were available, of which 65% had advanced-stage disease. Of the 20 patients, 9 underwent surgery, 6 received radiotherapy and 5 received chemotherapy as a first-line treatment. Treatment was generally well-tolerated. The median survival period was 35.8 months for all stages and 14.0 months for advanced stages. The treatment outcomes in our institution were favorable in comparison with previous studies from the USA and Europe, although these findings may be due to ethnic differences or the efficacy of treatment for HIV and lung cancer.
抗逆转录病毒疗法的出现改变了人类免疫缺陷病毒(HIV)感染者的疾病谱构成,而在美国和欧洲,非艾滋病定义性癌症(尤其是肺癌)导致的死亡发生率持续上升。然而,关于亚洲人群肺癌临床特征的详细报告却很有限。本研究回顾性分析了1988年至2013年期间在单一机构接受治疗的HIV合并肺癌患者的临床特征、治疗方案及预后。本研究纳入的20例HIV合并肺癌患者中,90%是在1996年之后的抗逆转录病毒时代被诊断出来的。CD4细胞计数中位数为373.5/µl,65%的患者被诊断为腺癌,30%为鳞状细胞癌。在可获取数据的11份标本中,有3份(27%)检测到表皮生长因子受体突变,其中65%为晚期疾病。20例患者中,9例接受了手术,6例接受了放疗,5例接受了化疗作为一线治疗。治疗总体耐受性良好。所有分期患者的中位生存期为35.8个月,晚期患者为14.0个月。与美国和欧洲以往的研究相比,我们机构的治疗效果较好,不过这些结果可能归因于种族差异或HIV及肺癌治疗的疗效。