Toxicity of combined modality treatment (CMT) for squamous cell carcinoma (SCC) of the anus in patients at risk for human immune deficiency virus (HIV) (Meeting abstract).

Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

Toxicity of combined modality treatment (CMT) for squamous cell carcinoma (SCC) of the anus in patients at risk for human immune deficiency virus (HIV) (Meeting abstract).

Proc Annu Meet Am Soc Clin Oncol; 12:A647 1993. Unique Identifier : AIDSLINE ICDB/93695046
Rosenblatt E; Chadha M; Malamud S; Pisch J; Berson A; Vikram B; Dept. of Radiation Oncology, Beth Israel Medical Center, New; York, NY 10003

Abstract: The experience of CMT for SCC of the anus in patients (pts) at risk for HIV infection is limited. This study analyzes the response and morbidity of CMT in risk groups, including homosexual males and iv drug users. Among the 10 pts studied, 7 were HIV-positive and HIV status was unknown in 3. One pt had Stage I, 4 had Stage II and 5 had Stage III disease. Radiation therapy (RT) included a pelvic field and conedown boost. The planned chemotherapy (CT) was 2 cycles of 5-FU and mitomycin C; 6 pts received concomitant azidothymidine. At completion of treatment, responses included 5 CR, 4 PR and 1 unevaluable due to acute skin morbidity. In pts with Stage I/II, 4/5 achieved CR; in pts with Stage III, 1/5 achieved CR. RTOG/EORTC toxicity score was 1 grade I, 3 grade II, 3 grade III, 3 grade IV perianal skin reaction. Five of the 6 grade III/IV reactions were in the HIV-positive pts. In 4 pts, grade II GI toxicity was noted; 1 pt had dysuria. The mean WBC nadir was 2600/mm3 (1000-5700/mm3); the mean platelet nadir was 188,000/mm3 (94,000-318,000/mm3). CT modification was required in 9/10 pts, including dose reduction, interruption or elimination of the 2nd cycle. Four pts had greater than 14 days break in RT. CMT for the early stage disease gives initial responses comparable to the literature. It appears that CMT should be offered to these pts despite the toxicity noted. However, for the advanced disease pts, the value of CMT in the face of poor response and enhanced morbidity is questionable.

Keywords: Anus Neoplasms/PATHOLOGY/*THERAPY Carcinoma, Squamous Cell/PATHOLOGY/*THERAPY Chemotherapy, Adjuvant Combined Modality Therapy Human HIV Infections/PATHOLOGY/*THERAPY Neoplasm Staging Radiotherapy Dosage Risk Factors ABSTRACT
931030
M93A0771

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