Objectives There has been limited data on management of cervical cancer in women living with HIV (WLWH) in modern antiretroviral therapy (ART) era in India. The study aimed to evaluate outcomes and toxicities of these patients treated with radiotherapy.
Methods A retrospective analysis of HIV-positive cervical cancer patients treated with radiotherapy between 2011 to 2018 was conducted.
Results Eighty-one HIV positive cervical cancer patients treated with radiotherapy were identified. Median age was 45 years of which seventy-three (90%) received radiotherapy with curative intent and eight patients received palliative radiotherapy. Median CD4 count at the start of treatment was 342 cells/mm3(IQR 241- 531). of 73 patients planned for definitive radiotherapy, concurrent cisplatin was planned in 52 (71%) patients with median of four chemotherapy cycles and 81% (n=59) patients received brachytherapy. Among the patients who received brachytherapy, the median dose prescribed was 80Gy. 77% patients completed their prescribed treatment. At a median follow-up of 37 months, 3-year DFS of patients planned with curative intent was 54%. On multivariate analysis, treatment completion was associated with favorable DFS. Grade III/IV acute gastrointestinal toxicity was seen in five (6.8%) patients while 30% patients had grade III/IV acute hematological toxicity. However, all these patients completed their planned radiotherapy with good supportive care.
Conclusions Standard treatment of chemoradiation should be planned in WLWH with well managed HIV presenting with locally advanced cervical cancer. Our study highlights need for optimal management of these patients by multidisciplinary team with intensive supportive care to ensure completion of planned treatment to achieve better outcomes.
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