Chemoradiotherapy completion and neutropenia risk in HIV patients with cervical cancer.

Medicine (Baltimore)

Hospital de Santa Maria, Centro Hospitalar Lisboa Norte Luis Costa Lab, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa Hospital da Luz, Lisboa, Portugal.

Published: July 2018

Cervical cancer (CC) is one of the acquired immunodeficiency syndrome (AIDS) defining diseases and the human immunodeficiency virus (HIV) infection is thought to relate with increased acute toxicity of chemoradiotherapy (CRT).We investigated the effect of HIV status in the incidence of neutropenia associated with cisplatin-based CRT for CC and its impact in treatment completion.This is a single-center retrospective cohort study. Data collection was performed for all the consecutive stage Ib-IV CC women treated with cisplatin-based CRT from 2012 to 2016, and with known HIV status.Sixty-one patients were included, 6 were HIV+. HIV+ patients had a higher risk of neutropenia at any cycle during cisplatin CRT [adjusted odds ratio (OR) 7.3, 95% confidence interval (95% CI) 1.02-52.3; P = .05]. Despite the absolute differences, mean neutrophil count was nonsignificantly lower in HIV+ women, both at baseline [4455/μL (interquartile range, IQR: 1830-6689) vs 6340 (IQR: 1720-18,970) for HIV-, P = .98] and at the end of treatment [1752/μL (IQR: 1100-2930) vs 3147/μL (IQR: 920-18,390) in HIV-; P = .06]. Moreover, when considering the effect of time, CRT seems to induce a consistent drop of neutrophils in both groups (P = .229). No febrile neutropenia events occurred.In HIV+ women, there were more CT cycle delays (P = .013), patients were more prone to use granulocyte colony-stimulating factor (G-CSF; HIV+ 40.0% vs HIV- 4.0%; P = .04) and less likely to complete at least 5 cycles of cisplatin (P = .02). All patients received adequate dose of pelvic RT, regardless of HIV status.HIV+ patients have a significantly increased risk of neutropenia during CRT treatment for CC and are less likely to complete chemotherapy with cisplatin.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078728PMC
http://dx.doi.org/10.1097/MD.0000000000011592DOI Listing

Publication Analysis

Top Keywords

cervical cancer
8
cisplatin-based crt
8
risk neutropenia
8
hiv+ women
8
patients
6
neutropenia
5
hiv
5
crt
5
hiv+
5
chemoradiotherapy completion
4

Similar Publications

This study examined the relationship between the vaginal microbiome, HPV infection, and cervical intraepithelial neoplasia (CIN) in 173 women. Subjects were grouped by HPV status and cervical lesion severity, ranging from HPV-negative to CIN Grade 2 or higher. Using VALENCIA classification, the study identified different community state types (CSTs) of vaginal microbiota, with CST IV subtypes (Staphylococcus dominated) showing high diversity and increased pathogenic bacteria.

View Article and Find Full Text PDF

Incorporating molecular testing for human papillomavirus (HPV) into the screening of cervical specimens can improve risk stratification and, in turn, patient management. Infection with a high-risk (HR) HPV genotype is associated with greater risk for persistent infection, viral integration, and progression of cervical neoplasia. Current guidelines consider HPV 16 or HPV 18 clinically actionable with referral to colposcopy; however, 12 Other HR HPV genotypes have been associated with cervical cancer risk, suggesting a benefit of extended genotyping.

View Article and Find Full Text PDF

Search for Healthcare and Breast/Gynecological Cancer Prevention Among Brazilian Lesbian Cisgender Women.

Cancer Invest

January 2025

Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto-SP, Brazil.

Although breast, cervical, endometrial, and ovarian cancers account for more than 43% of new cases in 2023 in Brazilian women, no national studies were found on the incidence, risk factors, and prevention of breast and gynecological neoplasms in lesbian women, causing the health needs of non-heterosexual women to go unnoticed by professionals. This study aims to identify and analyze the search for healthcare related to the prevention of breast/gynecological cancer among Brazilian lesbian cisgender women who have not had the disease. Seven lesbian women participated in this qualitative study.

View Article and Find Full Text PDF

Objective: The goal of this study was to better understand the epidemiology, clinical characteristics, and treatment outcomes of head and neck sarcomas using real-world data from Japan.

Methods: Using the Japanese Head and Neck Cancer Registry, we identified 438 patients who were pathologically diagnosed with head and neck sarcoma between 2011 and 2020. We compared epidemiological, clinical, and prognostic data for the different histological types of sarcoma.

View Article and Find Full Text PDF

Modeling dosimetric benefits from daily adaptive RT for gynecological cancer patients with and without knowledge-based dose prediction.

J Appl Clin Med Phys

January 2025

Department of Radiation Medicine and Applied Sciences, UC San Diego Health, La Jolla, California, USA.

Purpose: Daily online adaptive radiotherapy (ART) improves dose metrics for gynecological cancer patients, but the on-treatment process is resource-intensive requiring longer appointments and additional time from the entire adaptive team. To optimize resource allocation, we propose a model to identify high-priority patients.

Methods: For 49 retrospective cervical and endometrial cancer patients, we calculated two initial plans: the treated standard-of-care (Initial) and a reduced margin initial plan (Initial) for adapting with the Ethos treatment planning system.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!