Impact of Human Immunodeficiency Virus Infection on Survival and Acute Toxicities From Chemoradiation Therapy for Cervical Cancer Patients in a Limited-Resource Setting
To prospectively compare survival between human immunodeficiency virus (HIV)-infected versus HIV-uninfected cervical cancer patients who initiated curative chemoradiation therapy (CRT) in a limited-resource setting. Women with locally advanced cervical cancer with or without HIV infection initiating...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2018-05, Vol.101 (1), p.201-210 |
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| creator | Grover, Surbhi Bvochora-Nsingo, Memory Yeager, Alyssa Chiyapo, Sebathu Bhatia, Rohini MacDuffie, Emily Puri, Priya Balang, Dawn Ratcliffe, Sarah Narasimhamurthy, Mohan Gwangwava, Elliphine Tsietso, Sylvia Kayembe, Mukendi K.A. Ramogola-Masire, Doreen Dryden-Peterson, Scott Mahantshetty, Umesh Viswanathan, Akila N. Zetola, Nicola M. Lin, Lilie L. |
| description | To prospectively compare survival between human immunodeficiency virus (HIV)-infected versus HIV-uninfected cervical cancer patients who initiated curative chemoradiation therapy (CRT) in a limited-resource setting.
Women with locally advanced cervical cancer with or without HIV infection initiating radical CRT in Botswana were enrolled in a prospective, observational, cohort study from July 2013 through January 2015.
Of 182 women treated for cervical cancer during the study period, 143 women initiating curative CRT were included in the study. Eighty-five percent of the participants (122 of 143) had stage II/III cervical cancer, and 67% (96 of 143) were HIV-infected. All HIV-infected patients were receiving antiretroviral therapy (ART) at the time of curative cervical cancer treatment initiation. We found no difference in toxicities between HIV-infected and HIV-uninfected women. The 2-year overall survival (OS) rates were 65% for HIV-infected women (95% confidence interval [CI] 54%-74%) and 66% for HIV-uninfected women (95% CI 49%-79%) (P = .70). Factors associated with better 2-year OS on multivariate analyses included baseline hemoglobin >10 g/dL (hazard ratio [HR] 0.37, 95% CI 0.19-0.72, P = .003), total radiation dose ≥75 Gy (HR 0.52, 95% CI 0.27-0.97, P = .04), and age |
| doi_str_mv | 10.1016/j.ijrobp.2018.01.067 |
| format | Article |
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Women with locally advanced cervical cancer with or without HIV infection initiating radical CRT in Botswana were enrolled in a prospective, observational, cohort study from July 2013 through January 2015.
Of 182 women treated for cervical cancer during the study period, 143 women initiating curative CRT were included in the study. Eighty-five percent of the participants (122 of 143) had stage II/III cervical cancer, and 67% (96 of 143) were HIV-infected. All HIV-infected patients were receiving antiretroviral therapy (ART) at the time of curative cervical cancer treatment initiation. We found no difference in toxicities between HIV-infected and HIV-uninfected women. The 2-year overall survival (OS) rates were 65% for HIV-infected women (95% confidence interval [CI] 54%-74%) and 66% for HIV-uninfected women (95% CI 49%-79%) (P = .70). Factors associated with better 2-year OS on multivariate analyses included baseline hemoglobin >10 g/dL (hazard ratio [HR] 0.37, 95% CI 0.19-0.72, P = .003), total radiation dose ≥75 Gy (HR 0.52, 95% CI 0.27-0.97, P = .04), and age <40 years versus 40-59 years (HR 2.17, 95% CI 1.05-4.47, P = .03).
Human immunodeficiency virus status had no effect on 2-year OS or on acute toxicities in women with well-managed HIV infection who initiated curative CRT in Botswana. In our cohort, we found that baseline hemoglobin levels, total radiation dose, and age were associated with survival, regardless of HIV status.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2018.01.067</identifier><identifier>PMID: 29619965</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Age Factors ; AIDS VIRUS ; Anti-HIV Agents - therapeutic use ; Botswana ; Chemoradiotherapy - adverse effects ; Chemoradiotherapy - mortality ; COMPARATIVE EVALUATIONS ; Confidence Intervals ; Female ; HIV Infections - complications ; HIV Infections - drug therapy ; HIV Infections - mortality ; HIV Seronegativity ; HUMAN POPULATIONS ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Multivariate Analysis ; NEOPLASMS ; PATIENTS ; Prospective Studies ; RADIOLOGY AND NUCLEAR MEDICINE ; Radiotherapy Dosage ; Survival Rate ; TOXICITY ; Uterine Cervical Neoplasms - blood ; Uterine Cervical Neoplasms - complications ; Uterine Cervical Neoplasms - mortality ; Uterine Cervical Neoplasms - therapy</subject><ispartof>International journal of radiation oncology, biology, physics, 2018-05, Vol.101 (1), p.201-210</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-20b6ef75b3a379313fef29d5048f52e525fa675cea9c761ba6b6cf424416a1c3</citedby><cites>FETCH-LOGICAL-c491t-20b6ef75b3a379313fef29d5048f52e525fa675cea9c761ba6b6cf424416a1c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0360301618301810$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29619965$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/23082755$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Grover, Surbhi</creatorcontrib><creatorcontrib>Bvochora-Nsingo, Memory</creatorcontrib><creatorcontrib>Yeager, Alyssa</creatorcontrib><creatorcontrib>Chiyapo, Sebathu</creatorcontrib><creatorcontrib>Bhatia, Rohini</creatorcontrib><creatorcontrib>MacDuffie, Emily</creatorcontrib><creatorcontrib>Puri, Priya</creatorcontrib><creatorcontrib>Balang, Dawn</creatorcontrib><creatorcontrib>Ratcliffe, Sarah</creatorcontrib><creatorcontrib>Narasimhamurthy, Mohan</creatorcontrib><creatorcontrib>Gwangwava, Elliphine</creatorcontrib><creatorcontrib>Tsietso, Sylvia</creatorcontrib><creatorcontrib>Kayembe, Mukendi K.A.</creatorcontrib><creatorcontrib>Ramogola-Masire, Doreen</creatorcontrib><creatorcontrib>Dryden-Peterson, Scott</creatorcontrib><creatorcontrib>Mahantshetty, Umesh</creatorcontrib><creatorcontrib>Viswanathan, Akila N.</creatorcontrib><creatorcontrib>Zetola, Nicola M.</creatorcontrib><creatorcontrib>Lin, Lilie L.</creatorcontrib><title>Impact of Human Immunodeficiency Virus Infection on Survival and Acute Toxicities From Chemoradiation Therapy for Cervical Cancer Patients in a Limited-Resource Setting</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>To prospectively compare survival between human immunodeficiency virus (HIV)-infected versus HIV-uninfected cervical cancer patients who initiated curative chemoradiation therapy (CRT) in a limited-resource setting.
Women with locally advanced cervical cancer with or without HIV infection initiating radical CRT in Botswana were enrolled in a prospective, observational, cohort study from July 2013 through January 2015.
Of 182 women treated for cervical cancer during the study period, 143 women initiating curative CRT were included in the study. Eighty-five percent of the participants (122 of 143) had stage II/III cervical cancer, and 67% (96 of 143) were HIV-infected. All HIV-infected patients were receiving antiretroviral therapy (ART) at the time of curative cervical cancer treatment initiation. We found no difference in toxicities between HIV-infected and HIV-uninfected women. The 2-year overall survival (OS) rates were 65% for HIV-infected women (95% confidence interval [CI] 54%-74%) and 66% for HIV-uninfected women (95% CI 49%-79%) (P = .70). Factors associated with better 2-year OS on multivariate analyses included baseline hemoglobin >10 g/dL (hazard ratio [HR] 0.37, 95% CI 0.19-0.72, P = .003), total radiation dose ≥75 Gy (HR 0.52, 95% CI 0.27-0.97, P = .04), and age <40 years versus 40-59 years (HR 2.17, 95% CI 1.05-4.47, P = .03).
Human immunodeficiency virus status had no effect on 2-year OS or on acute toxicities in women with well-managed HIV infection who initiated curative CRT in Botswana. In our cohort, we found that baseline hemoglobin levels, total radiation dose, and age were associated with survival, regardless of HIV status.</description><subject>Adult</subject><subject>Age Factors</subject><subject>AIDS VIRUS</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Botswana</subject><subject>Chemoradiotherapy - adverse effects</subject><subject>Chemoradiotherapy - mortality</subject><subject>COMPARATIVE EVALUATIONS</subject><subject>Confidence Intervals</subject><subject>Female</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - mortality</subject><subject>HIV Seronegativity</subject><subject>HUMAN POPULATIONS</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>NEOPLASMS</subject><subject>PATIENTS</subject><subject>Prospective Studies</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Radiotherapy Dosage</subject><subject>Survival Rate</subject><subject>TOXICITY</subject><subject>Uterine Cervical Neoplasms - blood</subject><subject>Uterine Cervical Neoplasms - complications</subject><subject>Uterine Cervical Neoplasms - mortality</subject><subject>Uterine Cervical Neoplasms - therapy</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kVGL1DAUhYMo7uzqPxAJ-NyatE06eRGWsusODCjuIL6FNL3ZyTBNSpIOzj_yZ5rZ0VVfhMB9yPnuPZyD0BtKSkoof78r7S74fiorQpcloSXh7TO0oMtWFDVj356jBak5KeosvkCXMe4IIZS2zUt0UQlOheBsgX6sxknphL3Bd_OoHF6N4-z8AMZqC04f8Vcb5ohXzoBO1juc3_0cDvag9li5AV_rOQHe-O8ZSBYivg1-xN0WRh_UYNUjtNlCUNMRGx9wB5nWme6U0xDw5ywBlyK2Diu8tqNNMBRfIPo5aMD3kJJ1D6_QC6P2EV7_mldoc3uz6e6K9aePq-56XehG0FRUpOdgWtbXqm5FTWsDphIDI83SsApYxYziLdOghG457RXvuTZN1TSUK6rrK_ThvHaa-xEGnY0FtZdTsKMKR-mVlf_-OLuVD_4gmRAi550XvDsv8DFZGXMmoLfaO5fjk1VNllXLWFY1Z5UOPsYA5ukCJfJUr9zJc73yVK8kVOZ6M_b2b3dP0O8-_9iHHNHBQjg5yDXCYMPJwODt_y_8BBolvTY</recordid><startdate>20180501</startdate><enddate>20180501</enddate><creator>Grover, Surbhi</creator><creator>Bvochora-Nsingo, Memory</creator><creator>Yeager, Alyssa</creator><creator>Chiyapo, Sebathu</creator><creator>Bhatia, Rohini</creator><creator>MacDuffie, Emily</creator><creator>Puri, Priya</creator><creator>Balang, Dawn</creator><creator>Ratcliffe, Sarah</creator><creator>Narasimhamurthy, Mohan</creator><creator>Gwangwava, Elliphine</creator><creator>Tsietso, Sylvia</creator><creator>Kayembe, Mukendi K.A.</creator><creator>Ramogola-Masire, Doreen</creator><creator>Dryden-Peterson, Scott</creator><creator>Mahantshetty, Umesh</creator><creator>Viswanathan, Akila N.</creator><creator>Zetola, Nicola M.</creator><creator>Lin, Lilie L.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>OTOTI</scope><scope>5PM</scope></search><sort><creationdate>20180501</creationdate><title>Impact of Human Immunodeficiency Virus Infection on Survival and Acute Toxicities From Chemoradiation Therapy for Cervical Cancer Patients in a Limited-Resource Setting</title><author>Grover, Surbhi ; Bvochora-Nsingo, Memory ; Yeager, Alyssa ; Chiyapo, Sebathu ; Bhatia, Rohini ; MacDuffie, Emily ; Puri, Priya ; Balang, Dawn ; Ratcliffe, Sarah ; Narasimhamurthy, Mohan ; Gwangwava, Elliphine ; Tsietso, Sylvia ; Kayembe, Mukendi K.A. ; Ramogola-Masire, Doreen ; Dryden-Peterson, Scott ; Mahantshetty, Umesh ; Viswanathan, Akila N. ; Zetola, Nicola M. ; Lin, Lilie L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-20b6ef75b3a379313fef29d5048f52e525fa675cea9c761ba6b6cf424416a1c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>AIDS VIRUS</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Botswana</topic><topic>Chemoradiotherapy - adverse effects</topic><topic>Chemoradiotherapy - mortality</topic><topic>COMPARATIVE EVALUATIONS</topic><topic>Confidence Intervals</topic><topic>Female</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - mortality</topic><topic>HIV Seronegativity</topic><topic>HUMAN POPULATIONS</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>NEOPLASMS</topic><topic>PATIENTS</topic><topic>Prospective Studies</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Radiotherapy Dosage</topic><topic>Survival Rate</topic><topic>TOXICITY</topic><topic>Uterine Cervical Neoplasms - blood</topic><topic>Uterine Cervical Neoplasms - complications</topic><topic>Uterine Cervical Neoplasms - mortality</topic><topic>Uterine Cervical Neoplasms - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grover, Surbhi</creatorcontrib><creatorcontrib>Bvochora-Nsingo, Memory</creatorcontrib><creatorcontrib>Yeager, Alyssa</creatorcontrib><creatorcontrib>Chiyapo, Sebathu</creatorcontrib><creatorcontrib>Bhatia, Rohini</creatorcontrib><creatorcontrib>MacDuffie, Emily</creatorcontrib><creatorcontrib>Puri, Priya</creatorcontrib><creatorcontrib>Balang, Dawn</creatorcontrib><creatorcontrib>Ratcliffe, Sarah</creatorcontrib><creatorcontrib>Narasimhamurthy, Mohan</creatorcontrib><creatorcontrib>Gwangwava, Elliphine</creatorcontrib><creatorcontrib>Tsietso, Sylvia</creatorcontrib><creatorcontrib>Kayembe, Mukendi K.A.</creatorcontrib><creatorcontrib>Ramogola-Masire, Doreen</creatorcontrib><creatorcontrib>Dryden-Peterson, Scott</creatorcontrib><creatorcontrib>Mahantshetty, Umesh</creatorcontrib><creatorcontrib>Viswanathan, Akila N.</creatorcontrib><creatorcontrib>Zetola, Nicola M.</creatorcontrib><creatorcontrib>Lin, Lilie L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>OSTI.GOV</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grover, Surbhi</au><au>Bvochora-Nsingo, Memory</au><au>Yeager, Alyssa</au><au>Chiyapo, Sebathu</au><au>Bhatia, Rohini</au><au>MacDuffie, Emily</au><au>Puri, Priya</au><au>Balang, Dawn</au><au>Ratcliffe, Sarah</au><au>Narasimhamurthy, Mohan</au><au>Gwangwava, Elliphine</au><au>Tsietso, Sylvia</au><au>Kayembe, Mukendi K.A.</au><au>Ramogola-Masire, Doreen</au><au>Dryden-Peterson, Scott</au><au>Mahantshetty, Umesh</au><au>Viswanathan, Akila N.</au><au>Zetola, Nicola M.</au><au>Lin, Lilie L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Human Immunodeficiency Virus Infection on Survival and Acute Toxicities From Chemoradiation Therapy for Cervical Cancer Patients in a Limited-Resource Setting</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2018-05-01</date><risdate>2018</risdate><volume>101</volume><issue>1</issue><spage>201</spage><epage>210</epage><pages>201-210</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>To prospectively compare survival between human immunodeficiency virus (HIV)-infected versus HIV-uninfected cervical cancer patients who initiated curative chemoradiation therapy (CRT) in a limited-resource setting.
Women with locally advanced cervical cancer with or without HIV infection initiating radical CRT in Botswana were enrolled in a prospective, observational, cohort study from July 2013 through January 2015.
Of 182 women treated for cervical cancer during the study period, 143 women initiating curative CRT were included in the study. Eighty-five percent of the participants (122 of 143) had stage II/III cervical cancer, and 67% (96 of 143) were HIV-infected. All HIV-infected patients were receiving antiretroviral therapy (ART) at the time of curative cervical cancer treatment initiation. We found no difference in toxicities between HIV-infected and HIV-uninfected women. The 2-year overall survival (OS) rates were 65% for HIV-infected women (95% confidence interval [CI] 54%-74%) and 66% for HIV-uninfected women (95% CI 49%-79%) (P = .70). Factors associated with better 2-year OS on multivariate analyses included baseline hemoglobin >10 g/dL (hazard ratio [HR] 0.37, 95% CI 0.19-0.72, P = .003), total radiation dose ≥75 Gy (HR 0.52, 95% CI 0.27-0.97, P = .04), and age <40 years versus 40-59 years (HR 2.17, 95% CI 1.05-4.47, P = .03).
Human immunodeficiency virus status had no effect on 2-year OS or on acute toxicities in women with well-managed HIV infection who initiated curative CRT in Botswana. In our cohort, we found that baseline hemoglobin levels, total radiation dose, and age were associated with survival, regardless of HIV status.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29619965</pmid><doi>10.1016/j.ijrobp.2018.01.067</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0360-3016 |
| ispartof | International journal of radiation oncology, biology, physics, 2018-05, Vol.101 (1), p.201-210 |
| issn | 0360-3016 1879-355X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5999036 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Age Factors AIDS VIRUS Anti-HIV Agents - therapeutic use Botswana Chemoradiotherapy - adverse effects Chemoradiotherapy - mortality COMPARATIVE EVALUATIONS Confidence Intervals Female HIV Infections - complications HIV Infections - drug therapy HIV Infections - mortality HIV Seronegativity HUMAN POPULATIONS Humans Kaplan-Meier Estimate Middle Aged Multivariate Analysis NEOPLASMS PATIENTS Prospective Studies RADIOLOGY AND NUCLEAR MEDICINE Radiotherapy Dosage Survival Rate TOXICITY Uterine Cervical Neoplasms - blood Uterine Cervical Neoplasms - complications Uterine Cervical Neoplasms - mortality Uterine Cervical Neoplasms - therapy |
| title | Impact of Human Immunodeficiency Virus Infection on Survival and Acute Toxicities From Chemoradiation Therapy for Cervical Cancer Patients in a Limited-Resource Setting |
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