Five-year overall survival following chemoradiation therapy for locally advanced cervical carcinoma in women living with and without HIV infection in Botswana

Infectious Agents and Cancer

Allison Chambers¹  Memory Bvochora-Nsingo²  Dawn Balang²  Emily MacDuffie³  Nicola M. Zetola⁴  Surbhi Grover⁵  Lilie L. Lin⁶  Jessica M. George⁷  Shawna Tuli⁷  Sebathu Chiyapo⁸  Doreen Ramogola-Masire⁹ 

[1] Department of Family and Community Health, Penn State Health St. Joseph, Hershey, USA;Department of Oncology, Gaborone Private Hospital, Gaborone, Botswana;Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA;Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA;Botswana-University of Pennsylvania Partnership, Gaborone, Botswana;Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA;Princess Marina Hospital, Gaborone, Botswana;Botswana-University of Pennsylvania Partnership, Gaborone, Botswana;School of Medicine, University of Botswana, Gaborone, Botswana;Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA;Donald Bren School of Information & Computer Sciences, University of California Irvine, Irvine, USA;Princess Marina Hospital, Gaborone, Botswana;School of Medicine, University of Botswana, Gaborone, Botswana;Department of Obstetrics and Gynecology, University of Botswana, Gaborone, Botswana;

关键词: Cervical cancer;    Chemoradiation;    HIV;    Botswana;    Sub-Saharan Africa;    Low resource setting;    Survival outcomes;   

DOI  :  10.1186/s13027-021-00389-w

来源: Springer

【 摘 要 】

PurposeTo compare updated prospective 5-year survival outcomes of cervical cancer patients living with and without human immunodeficiency virus (HIV) infection who initiated curative chemoradiation therapy (CRT) in a resource-limited setting.Methods & MaterialsWomen in Botswana with locally advanced cervical cancer were enrolled in a prospective, observational, cohort study from July 2013 through January 2015. Survival outcomes were analyzed after 5 years of follow-up.ResultsThis cohort included 143 women initiating curative CRT. Sixty-seven percent (n = 96) of cohort were women living with HIV (WLWH), all of whom were receiving antiretroviral therapy (ART) at the time of treatment initiation and boasted a median CD4 count of 481 cells/μL (IQR, 351-579 μL). The 5-year overall survival (OS) rates were 56.8% (95% CI, 40.0–70.5%) for patients without HIV infection and 55.1% (95% CI, 44.2–64.7%) for WLWH (p = 0.732). Factors associated with superior 5-year OS on multivariate analyses included baseline hemoglobin > 10 g/dL (hazard ratio (HR) 0.90, 95% CI, 0.83–0.98, p = 0.015), lower stage at diagnosis (stage I and II vs. III and IV) (HR 1.39, 95% CI 1.09–1.76, p = 0.007), and higher EQD2 (HR 0.98, 95% CI 0.97–0.99, p = 0.001).ConclusionsFive-year OS was not impacted by HIV status in this population of WLWH with well-managed infection who initiated curative treatment for cervical cancer in Botswana. Regardless of HIV status, hemoglobin levels and stage at diagnosis were associated with survival. These findings suggest that treatment for cervical cancer in WLWH with well-controlled infection need not be altered solely due to HIV status.

【 授权许可】

CC BY