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Is the prognosis of Anal cancer worse in HIV
infected patients ?
•
Oehler – Janne et al ( 2008 )
•
40 consecutive HIV(+) patients from 4 centres in Switzerland, France & Canada
treated with CRT between 1997-2006
•
Compared with 81 HIV(-) patients
•
98 % SCC
HIV (+) HIV (-)
cCR
92% 96%
poorer local control experienced
by HIV(+) group with significantly
higher colostomy rate
5 yr local control
38% 87%*
5 yr sphincter preservation 38% 74%**
5 yr DM free survival
91% 84%
5 yr DSS
68% 85%***
5 yr OS
61% 65%
Acute G3/4 toxicity
48% 31%
Severe skin toxicity
35% 17%
Severe haematologic toxicity 33% 12%
( * P = 0.008 ; **p = 0.035 ; *** p = 0.09 )
Higher treatment related toxicity
Less use of MMC in HIV(+) group
Longer duration of RT in HIV(+)
group ( ? more treatment breaks)