Head and neck diffuse large B cell lymphomas (HN-DLBCL) in human immunodeficiency virus (HIV) positive patients: long-term results in the highly active antiretroviral therapy (HAART) era

Eur Arch Otorhinolaryngol. 2017 Oct;274(10):3735-3739. doi: 10.1007/s00405-017-4672-y. Epub 2017 Jul 12.

Abstract

To report long-term outcomes and toxicity rates after chemotherapy (CHT) followed by radiotherapy (RT) in the highly active antiretroviral therapy (HAART) era in human immunodeficiency virus (HIV) positive patients with head and neck diffuse large B cell lymphomas (HN-DLBCL). Clinical data concerning consecutive HIV patients treated for DLBCL located in head and neck region with CHT and RT were retrospectively reviewed. Systemic treatment consisted of combination CHT agents given with concomitant HAART and regimen was left to oncologists' discretion. Involved field RT was delivered at a total dose of 30-36 Gy (2 Gy per fraction). Survival rates were estimated using the Kaplan-Meier method. Toxicity was evaluated using National Cancer Institute's Common Terminology Criteria for Adverse Events. Overall, 13 patients were included. There were no missing data. Eight patients had advanced disease (stage III-IV = 8; 61.5%). The most common primary tumor location was oral cavity (n = 7) with large mass at presentation. All patients completed the programmed treatment. Severe acute toxicity was observed in one patient, only. Overall, three patients had died and no treatment-related deaths occurred. After a median follow-up of 152 months, the 20-year overall survival and disease-free survival rates were 65.9 and 41.5%, respectively. Globally, there were no RT-related late complications. This data analysis suggested that CHT followed by RT can be safety proposed in the management of patients with HIV-related HN-DLBCL in the HAART era. Further investigations are necessary to validate our results.

Keywords: Antiretroviral therapy; Chemotherapy; Head and neck; Lymphomas; Radiotherapy; Survival.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antiretroviral Therapy, Highly Active / methods
  • Disease-Free Survival
  • Female
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • HIV Seropositivity / diagnosis
  • Head and Neck Neoplasms* / etiology
  • Head and Neck Neoplasms* / pathology
  • Head and Neck Neoplasms* / therapy
  • Humans
  • Italy / epidemiology
  • Long Term Adverse Effects / diagnosis
  • Long Term Adverse Effects / epidemiology
  • Long Term Adverse Effects / etiology
  • Lymphoma, Large B-Cell, Diffuse* / etiology
  • Lymphoma, Large B-Cell, Diffuse* / pathology
  • Lymphoma, Large B-Cell, Diffuse* / therapy
  • Male
  • Middle Aged
  • Radiotherapy / methods
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome