Tolerance of patients with human immunodeficiency virus and anal carcinoma to treatment with combined chemotherapy and radiation therapy.

Purpose: To evaluate treatment tolerance in patients with and without the human immunodeficiency virus (HIV) who were undergoing treatment of anal cancer.
Materials and Methods: The authors retrospectively reviewed the medical records of 62 patients with anal cancer who received radiation treatment. Seven patients had HIV, four of whom had acquired immunodeficiency syndrome. Fifty-five patients were HIV negative, including 11 patients identified as being at high risk for HIV infection whose status was unknown.
Results: Thirty of the 55 (55%) patients who were HIV negative required treatment breaks of a mean duration of 16.7 days. Four of those 55 (7%) patients required hospitalization. Three of 42 (7%) patients who were HIV negative receiving chemotherapy required chemotherapy dose reduction. All seven patients with HIV required treatment breaks of a mean duration of 21.7 days. Three of the seven (43%) patients required hospitalization. Four of the seven (57%) patients required chemotherapy dose reduction.
Conclusion: Patients with HIV undergoing treatment of anal cancer have increased toxic reactions to chemoradiation. Treatment must be individually tailored on the basis of extent of disease and degree of compromise of the immune system.