Good tolerance and long-term complete remission after definitive intensity-modulated radiotherapy for locally advanced head and neck cancer in a patient with human immunodeficiency virus infection: A case report and literature review

Head Neck. 2015 Dec;37(12):E186-90. doi: 10.1002/hed.24058. Epub 2015 Jun 15.

Abstract

Background: The main concerns with radiation therapy for head and neck cancer in human immunodeficiency virus (HIV)-infected patients include limited tumor response and profound mucosal or skin toxicities under severe immunocompromised status.

Methods: In this study, we describe the clinicopathological features, chronological changes in HIV viral loads and CD4 counts, and treatment outcomes of definitive radiotherapy for locally advanced head and neck cancer in an HIV-infected patient.

Results: Despite low CD4 counts (80 cells/µL), a combination of highly active antiretroviral therapy (HAART) and definitive concurrent chemoradiotherapy (70 Gy of simultaneously integrated boost intensity-modulated radiotherapy (IMRT), fluorouracil, and leucovorin) was well-tolerated. Grade 3 mucositis and dermatitis were resolved 2 weeks after treatment completion. The patient was alive and remained disease-free 31 months after treatment.

Conclusion: For patients with HIV diagnosed with locally advanced head and neck cancer, good tolerance and outcome can be achieved with definitive radiotherapy while on HAART.

Keywords: CD4; head and neck cancer; human immunodeficiency virus; immunocompromised; radiotherapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antiretroviral Therapy, Highly Active / methods*
  • CD4 Lymphocyte Count
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy, Adjuvant* / methods
  • HIV Infections / complications
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • Head and Neck Neoplasms / complications
  • Head and Neck Neoplasms / diagnosis
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Immunocompromised Host*
  • Laryngeal Neoplasms / therapy
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Radiotherapy Dosage
  • Radiotherapy, Intensity-Modulated* / methods
  • Remission Induction
  • Treatment Outcome
  • Viral Load / drug effects