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Effect of hiv serological status on outcome in patients with cancer of cervix treated with radiotherapy
Abstract
Objectives: To investigate and compare the outcomes of invasive cervical cancer patients with known HIV serostatus treated with radiotherapy.
Design: A retrospective study.
Setting: Mulago Hospital Radiotherapy Department, Kampala, Uganda.
Subjects: Medical records of thirty six patients treated in our department between May and July 2000, whose serostatus and CD4 counts were known, was done after a four-year period to determine the outcomes and survival after radiotherapy.
Results: Of these, 29 (80.6%) were HIV seronegative and seven (19.4%) were HIV seropositive. All the seropositive patients had advanced disease (stage IIB and above) and only two (6.9%) among the seronegative patients had early disease (less than stage IIB) at presentation. The mean CD4 count was 289 (±122 SD) for the seropositive and 550 (± 237 SD) for the seronegative patients (p = 0.008). About 60% of all the patients received both external beam and intracavitary treatment. The one, two and three year survival probabilities (Kaplan-Meier) for the seropositive were 67%, 40% and 27% respectively while they were 89%, 62% and 51% for the seronegative patients. By the fourth year the survival probabilities had fallen to 0% for the seropositive while it was 46% for the seronegative patients.
Conclusion: Radiotherapy was effective in both sets of patients with comparable good objective response. The survival probabilities for the seropositive patients were significantly lower than for the seronegative patients at all periods with a P-value of 0.0001 by the fourth year.
The East African Medical Journal Vol. 83(8) 2006: 416-423
Design: A retrospective study.
Setting: Mulago Hospital Radiotherapy Department, Kampala, Uganda.
Subjects: Medical records of thirty six patients treated in our department between May and July 2000, whose serostatus and CD4 counts were known, was done after a four-year period to determine the outcomes and survival after radiotherapy.
Results: Of these, 29 (80.6%) were HIV seronegative and seven (19.4%) were HIV seropositive. All the seropositive patients had advanced disease (stage IIB and above) and only two (6.9%) among the seronegative patients had early disease (less than stage IIB) at presentation. The mean CD4 count was 289 (±122 SD) for the seropositive and 550 (± 237 SD) for the seronegative patients (p = 0.008). About 60% of all the patients received both external beam and intracavitary treatment. The one, two and three year survival probabilities (Kaplan-Meier) for the seropositive were 67%, 40% and 27% respectively while they were 89%, 62% and 51% for the seronegative patients. By the fourth year the survival probabilities had fallen to 0% for the seropositive while it was 46% for the seronegative patients.
Conclusion: Radiotherapy was effective in both sets of patients with comparable good objective response. The survival probabilities for the seropositive patients were significantly lower than for the seronegative patients at all periods with a P-value of 0.0001 by the fourth year.
The East African Medical Journal Vol. 83(8) 2006: 416-423
