Concomitant chemoradiotherapy and antiretroviral therapy for HIV-infected patients with locoregionally advanced non-small cell lung cancer: benefit and tolerability of treatment in 2 cases.

Abstract

Background: Human immunodeficiency virus (HIV)-infected patients are surviving longer since the advent of antiretroviral therapy. Therefore, more patients are developing non-AIDS-defining cancers which increasingly determine mortality.

Case reports: Here we present 2 cases of locally advanced non-small cell lung cancer treated initially with concomitant chemoradiotherapy and antiretroviral therapy. Both patients were male, ages 69 and 66, with known HIV infection and immunologically stable on antiretroviral therapy. Presenting symptoms included superior sulcus tumor with left arm immobility and sensory disturbance in case 1 and right lower bronchus constriction in case 2. Symptoms were controlled by chemoradiotherapy.

Conclusion: These cases illustrate that intensive anticancer therapy administered to the HIV-infected population can be tolerated even though these patients seem to be too fragile for both chemotherapy and radiotherapy, especially since the potential benefit remains uncertain. Recent improvements in chemoradiotherapy and supportive care have enhanced tolerance for such therapy.