The impact of HIV infection on women receiving radiation for cervical cancer

  • Mapule Mangena University of Pretoria
  • Leon C Snyman University of Pretoria
  • Greta Dreyer University of Pretoria
  • Sheynaz Bassa University of Pretoria
  • Piet J Becker University of Pretoria and Medical Research Council
Keywords: HIV, cervical cancer, radiotherapy, overall survival, treatment outcomes

Abstract

Background: The objective of the study was to compare patient characteristics, treatment toxicity and interruptions, and survival in human immunodeficiency virus (HIV)-positive and HIV-negative cervical cancer patients receiving radiation as primary or adjuvant treatment. Method: Demographics, clinical and tumour characteristics, and the outcomes of 51 HIV-positive and 47-HIV negative consecutive cervical cancer patients were assessed and compared, including co-morbidities, performance status, treatment type and toxicities, and survival. Results: HIV-positive women were 13 years younger (p < 0.001), more often had anaemia (p 0.021) and needed pretreatment blood transfusion (p 0.037) more often than HIV-negative women. Performance status, kidney function, International Federation of Gynecology and Obstetrics stage, histology types and treatment intent and planning did not differ between the two groups. Treatment interruptions (p 0.004), transfusion during treatment (p 0.012), treatment toxicities (p 0.040) and average deficit (p 0.021) occurred significantly more in HIV-positive patients. Survival was significantly worse in HIV-positive women (p 0.029) and was associated with insufficient radiation (p < 0.001) and treatment interruptions (p 0.051). Conclusion: In spite of being younger, the pretreatment correction of anaemia and the prescription of sufficient radiation dosages, HIV-infected cervical cancer patients experienced poorer survival. Treatment interruption and incomplete radiation contributed to poor outcomes.

Author Biographies

Mapule Mangena, University of Pretoria
BMedSc (Hons), MBChB, MMed (O&G), FCOG (SA) Gynaecologic Oncology Unit Department Obstetrics & Gynaecology University of Pretoria Pretoria
Leon C Snyman, University of Pretoria
MBChB, MPraxMed, MMed (O&G), FCOG (SA) Gynaecologic Oncology Unit Department Obstetrics & Gynaecology University of Pretoria Pretoria
Greta Dreyer, University of Pretoria
MBChB, MMed (O&G), MCOG (SA), PhD Gynaecologic Oncology Unit Department Obstetrics & Gynaecology University of Pretoria Pretoria
Sheynaz Bassa, University of Pretoria
MBChB, FC Rad Onc (SA) Department Radiation Oncology University of Pretoria Pretoria
Piet J Becker, University of Pretoria and Medical Research Council
BSc(Hons), MSc, PhD Research Office Faculty of Health Sciences University of Pretoria Pretoria
Published
2015-06-05
Section
Original Research