Chadha M, Rosenblatt E A, Malamud S, Pisch J, Berson A
Department of Radiation Oncology, Beth Israel Medical Center, New York, New York 10003.
Dis Colon Rectum. 1994 Sep;37(9):861-5. doi: 10.1007/BF02052589.
Patients diagnosed as having anal cancer and human immunodeficiency virus (HIV)-positive disease were evaluated for response to treatment and its associated toxicity.
We studied nine HIV-positive patients with squamous-cell carcinoma of the anus. Among them, three patients had acquired immunodeficiency syndrome (AIDS). The stage of disease at presentation included: one Stage 0, two Stage I, two Stage II, and four Stage III patients. Seven patients received combined modality treatment, i.e., radiation therapy and chemotherapy, and two patients received radiation therapy alone. The radiation therapy field included the pelvis and a conedown boost. Chemotherapy consisted of two cycles of 5-fluorouracil and mitomycin C. Patients have been followed from 2 to 42 (median, 8) months.
Seven patients achieved a complete response clinically. All Stage I/II patients and one of four Stage III patients remain alive and have no evidence of disease. Radiation Therapy Oncology Group/European Organization for the Research and Treatment of Cancer Grades 3 and 4 skin toxicity were noted in six patients, and Grades 2 and 3 myelosuppression were noted in eight patients. The response rates achieved are comparable to the experience in non-HIV patients reported in the literature, but toxicity seems to be increased.
It would seem reasonable to offer combined modality treatment to early stage, HIV-positive patients with good performance status and a history of minor opportunistic infections. The value of combined modality in AIDS patients and those who present with advanced stages of the disease is questionable.
对诊断为肛管癌且合并人类免疫缺陷病毒（HIV）阳性疾病的患者进行治疗反应及其相关毒性评估。
我们研究了9例HIV阳性的肛管鳞状细胞癌患者。其中，3例患有获得性免疫缺陷综合征（AIDS）。就诊时疾病分期包括：1例0期、2例I期、2例II期和4例III期患者。7例患者接受了综合治疗，即放疗和化疗，2例患者仅接受了放疗。放疗野包括盆腔及缩野加量照射。化疗由两个周期的5-氟尿嘧啶和丝裂霉素C组成。对患者进行了2至42个月（中位时间8个月）的随访。
7例患者临床达到完全缓解。所有I/II期患者及4例III期患者中的1例仍存活，且无疾病证据。6例患者出现了放射治疗肿瘤学组/欧洲癌症研究与治疗组织3级和4级皮肤毒性，8例患者出现了2级和3级骨髓抑制。所达到的缓解率与文献报道的非HIV患者的经验相当，但毒性似乎有所增加。
对于身体状况良好且有轻微机会性感染史的早期HIV阳性患者，提供综合治疗似乎是合理的。综合治疗对AIDS患者及疾病晚期患者的价值值得怀疑。
