Squamous-cell carcinoma of the anus in HIV-positive patients

Chadha, Manjeet; Rosenblatt, E.; Malamud, S.; Pisch, Julianna; Berson, Anthony M.

doi:10.1007/bf02052589

Cited by 81 publications

(39 citation statements)

References 20 publications

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“…Their HIV-positive patients had a 29 percent two-year survival. Chadha et al 12 reported the results of treating nine patients with HIV, eight of whom were available for a median follow-up of eight months. Although only one patient was able to complete the prescribed XRT and two cycles of chemotherapy with 5-fluorouracil and mitomycin C, seven patients revealed a complete clinical response.…”

Section: Discussionmentioning

confidence: 98%

Outcome of HIV-Infected Patients With Invasive Squamous-Cell Carcinoma of the Anal Canal in the Era of Highly Active Antiretroviral Therapy

Stadler¹,

Gregorcyk²,

Euhus³

et al. 2004

Diseases of the Colon &Amp; Rectum

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A review of patients with HIV and invasive squamous-cell carcinoma of the anal canal suggests a trend toward a higher CD4 count at the time of diagnosis and improved survival in patients receiving highly active antiretroviral therapy. In this new era, HIV-positive patients should be on highly active antiretroviral therapy. If not, highly active antiretroviral therapy should be initiated, and standard multimodality therapies for invasive squamous-cell carcinoma of the anal canal are recommended.

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Section: Discussionmentioning

confidence: 98%

Outcome of HIV-Infected Patients With Invasive Squamous-Cell Carcinoma of the Anal Canal in the Era of Highly Active Antiretroviral Therapy

Stadler¹,

Gregorcyk²,

Euhus³

et al. 2004

Diseases of the Colon &Amp; Rectum

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“…11,12 But this regimen is poorly tolerated by HIV+ patients and some authors have recommended lowering the dose and/or intensity of chemotherapy or radiotherapy. 13,14 Most of the patients from such studies were treated before the era of HAART. The availability of these new agents has rapidly changed the natural history and therapeutic results obtained in AIDS patients.…”

mentioning

confidence: 99%

Anal Carcinomas in HIV-Positive Patients: High-Dose Chemoradiotherapy Is Feasible in the Era of Highly Active Antiretroviral Therapy

Blazy

Hennequin

Gornet

et al. 2005

Diseases of the Colon &Amp; Rectum

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“…Given the long-term survival rates that are possible for HIVinfected patients under modern antiretroviral combination therapy [14], long-term side effects of organ-preservative therapy are of interest. In our experience and that of others T2 N1 M0 T1 N0 M0 T3 N2 M0 T2 N0 M0 T1 N0 M0 T2 N0 M0 HIV-positive since (years) [5,8,15], there is no increased late complication rate and the reported side effects (1 patient with grade 1 anal stenosis, 1 patient with grade 2 pelvic and defecation pain) do not compromise the ability to participate in everyday life.…”

Section: Discussionmentioning

confidence: 75%

“…Initial reports on combined modality therapy for HIV-infected patients with epidermoid cancer of the anal canal were more or less casuistic contributions on treatment tolerance, rarely differentiating between patients with good performance status and those with fully developed AIDS. More than half of the patients described by Bottomley et al [7] (n = 5 patients), Peddada et al [5] (n = 8), Chadha et al [8] (n = 9), and Holland and Swift [15] (n = 7) needed treatment interruptions due to excessive side effects, even though treatment schedules in many cases already had been modified from institutional standards. The results reported here are an extension of a prior report [13] with long-term follow-up now available.…”

Section: Discussionmentioning

confidence: 99%

“…Although they share pathogenetic features, anal cancer, in contrast to cervical cancer, is not an AIDS-defining malignancy [3,4]. Due to the fear to further reduce the patient's already compromised immune system and because of reports on unexpectedly grave side effects [5][6][7][8] of aggressive therapy, there is no consensus how to treat HIVinfected patients with cancer of the anal canal.…”

Section: Introductionmentioning

confidence: 99%

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Cancer of the Anal Canal and HIV Infection: Toxicity and Results of Organ Preservation with Radiochemotherapy or Radiotherapy

Höcht¹,

Wiegel²,

Runkel³

et al. 2000

Oncol Res Treat

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Background: Anal cancer is an evolving problem in HIV-infected patients. In fear of excessive toxicity in patients with HIV infection, aggressive therapy is often withheld. Patients and Methods: From January 1995 to October 1997, 6 patients with epidermoid cancer of the anal canal and a long history of HIV infection but without symptoms of AIDS or repeated severe infections were treated with radiotherapy (1 patient) or radiochemotherapy (5 patients). External beam radiotherapy with 45 Gy to the tumor and pelvic as well as inguinal lymphatic drainage were administered. An additional small-field boost of 5.4–9 Gy was given in larger tumors or, at the end of the reported time span, to enhance the cumulative dose (1 patient). Chemotherapy consisted of 5-fluorouracil (5-FU) 1000 mg/m²/24 h, days 1–4, two cycles, and mitomycin C either 1 × 15 mg/m², day 1 in the 1st week, or 2 × 10 mg/m², day 1 in the 1st and 5th weeks of radiotherapy. Results: Besides one reproducible event of cardiovascular grade 3 toxicity due to 5-FU, acute reactions were mild to moderate in all patients, and all but one radiotherapy treatments could be given as scheduled (1 patient with a delay of 4 days). With a median observation time of 24 (10–44) months, 4 out of 6 patients have their disease controlled, one progressed locally without ever achieving even a partial remission and died of disease, whereas the remaining patient had a local recurrence and distant metastasis at 18 months. Conclusion: Chemoradiation with standard doses of 5-FU and mitomycin C can be offered to patients with HIV infection and cancer of the anal canal who are in good general condition and do not suffer from a compromised immune system. In these patients, side effects and outcome are comparable to those in non-HIV-infected patients.

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Squamous-cell carcinoma of the anus in HIV-positive patients

Cited by 81 publications

References 20 publications

Outcome of HIV-Infected Patients With Invasive Squamous-Cell Carcinoma of the Anal Canal in the Era of Highly Active Antiretroviral Therapy

Outcome of HIV-Infected Patients With Invasive Squamous-Cell Carcinoma of the Anal Canal in the Era of Highly Active Antiretroviral Therapy

Anal Carcinomas in HIV-Positive Patients: High-Dose Chemoradiotherapy Is Feasible in the Era of Highly Active Antiretroviral Therapy

Cancer of the Anal Canal and HIV Infection: Toxicity and Results of Organ Preservation with Radiochemotherapy or Radiotherapy

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