Concurrent chemoradiotherapy with 5-fluorouracil and mitomycin C for anal carcinoma: Are there differences between HIV-positive and HIV-negative patients in the era of highly active antiretroviral therapy?

Abstract Purpose To report treatment compliance, toxicity and clinical outcome of chemoradiotherapy (CRT) for anal carcinoma in HIV-negative vs. HIV-positive patients treated with highly active antiretroviral therapy. Material and methods Between 1997 and 2008, 25 HIV-positive and 45 HIV-negative patients received CRT (50.4Gy at 1.8Gy/fraction plus 5.4–10.8Gy boost; 5-fluorouracil, 1000mg/m 2 , Days 1–4 and 29–32, mitomycin C, 10mg/m 2 , Days 1 and 29). Median follow-up was 51 (range, 3–235) months. Results HIV-positive patients were significantly younger (mean age, 47 vs. 57years, p p p =0.79). Initial complete response (84% vs. 93%, p =0.41), 5-year rates of local control (65% vs. 78%, p =0.44), cancer-specific (78% vs. 90%, p =0.17) and overall survival (71% vs. 77%, p =0.76) were not significantly different. Conclusion HIV-positive patients with anal cancer can be treated with standard CRT, with the same tolerability and toxicity as HIV-negative patients. Long-term local control and survival rates are not significantly different between these groups.