Management of Head and Neck Cancers With or Without Comorbid HIV Infection in Botswana.
Adult
Aged
Anti-HIV Agents
/ therapeutic use
Botswana
/ epidemiology
Comorbidity
Female
Follow-Up Studies
HIV
/ isolation & purification
HIV Infections
/ diagnosis
Head and Neck Neoplasms
/ diagnosis
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Staging
Prospective Studies
Risk Factors
Time-to-Treatment
/ statistics & numerical data
Treatment Outcome
Viral Load
Global oncology
HIV-related neoplasms
HPV-related malignancies
Head and neck neoplasms
Radiotherapy
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
24
09
2020
received:
06
07
2020
accepted:
13
10
2020
pubmed:
25
10
2020
medline:
8
5
2021
entrez:
24
10
2020
Statut:
ppublish
Résumé
Head and neck cancer (HNC) is the fifth most common malignancy in sub-Saharan Africa, a region with hyperendemic human immunodeficiency virus (HIV)-infection. HIV patients have higher rates of HNC, yet the effect of HIV-infection on oncologic outcomes and treatment toxicity is poorly characterized. Prospective observational cohort study. HNC patients attending a government-funded oncology clinic in Botswana were prospectively enrolled in an observational cohort registry from 2015 to 2019. Clinical characteristics were analyzed via Cox proportional hazards and logistic regression followed by secondary analysis by HIV-status. Overall survival (OS) was evaluated via Kaplan-Meier. The study enrolled 149 patients with a median follow-up of 23 months. Patients presented with advanced disease (60% with T4-primaries), received limited treatment (19% chemotherapy, 8% surgery, 29% definitive radiation [RT]), and had delayed care (median time from diagnosis to RT of 2.5 months). Median OS was 36.2 months. Anemia was associated with worse survival (HR 2.74, P = .001). Grade ≥ 3 toxicity rate with RT was 30% and associated with mucosal subsite (OR 4.04, P = .03) and BMI < 20 kg/m Despite access to government-funded care, HNC patients in Botswana present late and have delays in care, which likely contributes to suboptimal survival outcomes. While a disproportionate number has comorbid HIV infection, HIV-status does not adversely affect outcomes. 2c Laryngoscope, 131:E1558-E1566, 2021.
Identifiants
pubmed: 33098322
doi: 10.1002/lary.29206
pmc: PMC8046722
mid: NIHMS1670654
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
E1558-E1566Subventions
Organisme : NCI NIH HHS
ID : K08 CA230170
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI045008
Pays : United States
Informations de copyright
© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).
Références
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Cancer. 2019 May 15;125(10):1645-1653
pubmed: 30801696
Lancet. 2007 Jul 7;370(9581):59-67
pubmed: 17617273
J Natl Cancer Inst. 2009 Aug 19;101(16):1120-30
pubmed: 19648510
Lancet Oncol. 2013 Jul;14(8):e290-1
pubmed: 23816293
PLoS One. 2015 Aug 12;10(8):e0135602
pubmed: 26267867
Oncologist. 2016 Jun;21(6):731-8
pubmed: 27053501
Clin Infect Dis. 2012 Nov;55(9):1228-35
pubmed: 22776851
Clin Epidemiol. 2011;3:217-27
pubmed: 21857789
Oncologist. 2018 Dec;23(12):1453-1460
pubmed: 30082488
Int J Radiat Oncol Biol Phys. 2018 May 1;101(1):201-210
pubmed: 29619965
J Clin Oncol. 2016 Jan 1;34(1):27-35
pubmed: 26578607
Acta Otolaryngol. 2007 Nov;127(11):1218-21
pubmed: 17851930
J Glob Oncol. 2018 Dec;4:1-9
pubmed: 30532993
J Natl Cancer Inst. 2000 Sep 20;92(18):1500-10
pubmed: 10995805
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593
JAMA Otolaryngol Head Neck Surg. 2020 Mar 1;146(3):291-297
pubmed: 31944228
N Engl J Med. 2019 Jul 18;381(3):230-242
pubmed: 31314967
Pan Afr Med J. 2011;10:31
pubmed: 22187613
East Afr Med J. 2006 Apr;83(4):85-91
pubmed: 16863003
J Infect Dis. 2004 Feb 15;189(4):686-98
pubmed: 14767823
J Clin Oncol. 2009 Feb 20;27(6):884-90
pubmed: 19114688
Lancet Oncol. 2015 Sep;16(10):1153-86
pubmed: 26419354
Cancer Epidemiol Biomarkers Prev. 2012 Jan;21(1):122-33
pubmed: 22045700
Scand J Public Health. 2018 Feb;46(1):27-36
pubmed: 28669281
West Afr J Med. 2004 Oct-Dec;23(4):280-5
pubmed: 15730084
Head Neck Oncol. 2009 May 28;1:14
pubmed: 19476614