人类免疫缺陷病毒阳性宫颈癌症患者联合治疗急性毒性:资源紧张中心的经验

IF 0.1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Abdullahi Adamu, M. Mustapha, Ayodeji Olasinde, Campbell Oladapo
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引用次数: 2

摘要

背景与目的:确定对人类免疫缺陷病毒(HIV)血清阳性的侵袭性癌症宫颈癌患者进行根治性联合治疗的急性毒性。受试者和方法:这是对2012年1月至2017年12月在我院放疗和肿瘤中心治疗侵袭性宫颈癌症的HIV-血清阳性患者的回顾性回顾。从患者的临床病例记录中提取患者的社会人口统计学、疾病特征和急性治疗引起的毒性,并进行研究。结果:对83例经组织学诊断为浸润性癌症的HIV确诊患者进行了研究。他们出现时的中位年龄为37.8岁。宫颈癌症最常见的症状是大量的臭味阴道分泌物,占39.8%。63例(85.6%)患者表现为东方肿瘤合作组0和2级,74例(89.2%)患者表现出国际妇产科联合会2B级及以上。74名(89.2%)患者获得了高活性抗逆转录病毒治疗。55名(66.3%)患者开始接受根治性放化疗,其中28名(50.1%)患者完成了规定的外照射放疗。13例(15.7%)患者通过症状治疗控制了宫颈癌症的症状。同时放化疗似乎耐受性差,该治疗组中有25名(71.4%)患者出现3级或4级毒性。17.9%和25%的患者出现3级血液学和胃肠道(GIT)毒性,而21.4%的患者出现4级皮肤毒性,导致治疗延迟和中断。在接受姑息治疗的患者中,症状得到了极好的缓解。结论:放射治疗和化疗是这些患者中选择的一组有效的治疗方式,这些患者的症状控制良好,与宫颈癌症相关。姑息性放射治疗在缓解宫颈癌症症状方面对表现不佳的患者也是有效的。需要进行进一步的研究,以确定对这些患者进行放疗和/或化疗的最佳管理,以减少治疗引起的毒性,从而最大限度地减少治疗中断和延误,最终改善他们的总体结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Acute toxicity to radical combination treatment in human immunodeficiency virus-positive cervical cancer patients: Experience from a resource-constrained center
Background and Purpose: To determine acute toxicity to radical combination treatment in invasive cervical cancer patients seropositive to human immunodeficiency virus (HIV). Subjects and Methods: This is a retrospective review of HIV-seropositive patients managed for invasive cervical cancer between January 2012 and December 2017 at the radiotherapy and oncology center of our institution. Patients' sociodemographics, disease characteristics, and acute treatment-induced toxicity were extracted from their clinical case notes and were studied. Results: A total of 83 confirmed HIV patients with histologically diagnosed invasive cervical cancer were studied. Their median age at presentation was 37.8 years. The most common presenting symptom of cervical cancer was copious foul-smelling vaginal discharge accounting for 39.8%. Sixty-three (85.6%) patients presented with Eastern Cooperative Oncology Group performance status of 0 and 2 and 74 (89.2%) patients presented with International Federation of Gynecologists and Obstetricians Stage 2B and above. Seventy-four (89.2%) patients had access to highly active antiretroviral therapy. Fifty-five (66.3%) patients were started on radical chemoradiation of which 28 (50.1%) completed prescribed external beam radiotherapy. Thirteen (15.7%) patients were treated symptomatically to control symptoms of cervical cancer. Concurrent chemoradiation appears to be poorly tolerated with 25 (71.4%) of the patients in this arm of treatment developing either Grade 3 or 4 toxicities. Grade 3 hematologic and gastrointestinal tract (GIT) toxicity was seen in 17.9% and 25% of the patients, respectively, while 21.4% of the patients presented with Grade 4 skin toxicity, leading to treatment delays and interruptions. There was excellent symptomatic relief in patients treated with palliative intent. Conclusions: Radiotherapy and chemotherapy are effective modalities of treatment in a selected group of these set of patients with good control of symptoms related to cervical cancer. Palliative radiotherapy is also effective in patients with poor performance status in relieving symptoms of cervical cancer. Further research needed to be done to identify the optimum management of these patients with radiotherapy and/or chemotherapy to reduce treatment-induced toxicity, thereby minimizing treatment interruptions and delays which ultimately will improve their overall outcome.
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来源期刊
West African Journal of Radiology
West African Journal of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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