Standard treatments for head and neck cancer less effective in HIV-positive patients
Radiation therapy with or without chemotherapy is less effective for patients with HIV when compared to the recurrence and overall survival rates in patients who do not have HIV, according to a study presented at the Multidisciplinary Head and Neck Cancer Symposium.
Treating head and neck cancer in HIV-positive patients is a challenge for oncologists. Because of the advancements in treating HIV, these patients are living much longer and therefore have a much higher chance of developing an HIV-related cancer. However, despite using treatments that are successful in HIV-negative cancer patients, HIV-positive patients experience much worse outcomes.
In the largest single institution study of its kind, researchers retrospectively studied 71 HIV-positive head and neck cancer patients treated between 1997 and 2010. Patients were followed for approximately 47 months and the rates of recurrence and overall survival were very high at 69 percent and 55 percent, respectively. Ten percent of patients also developed a second primary malignancy within five years after receiving radiation therapy.
The study authors concluded that neither radiation nor radiation plus chemotherapy, both standard treatments for head and neck cancer, were as effective for HIV-positive patients when compared to HIV-negative patients and that more research was needed to develop treatments that can reduce the risk of recurrence and increase survival rates.
"Treating HIV-positive patients with head and neck cancers is extremely difficult, but becoming much more commonplace due to the advances in therapies that prolong the life of these patients," Waleed Mourad, MD, MSc, PhD, lead author of the study and a radiation oncologist at Beth Israel Medical Center in New York, said. "It is extremely important that we establish multimodality approaches and regimens that are better tailored to improve outcomes in HIV-positive head and neck cancer patients and minimize treated related co-morbidities."