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Head and Neck Surgery

(503) Toxicity of Head and Neck Cancer Radiotherapy in HIV-positive Patients

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Co-Author(s)

  • NT

    Natasha D. Tillett, MD

    Resident Physician - PGY1
    Yale New Haven Hospital
    West Haven, Connecticut, United States

    • Presenting Author(s)

  • Stephen F. White, MD

    Resident Physician
    University of Tennessee Department of Otolaryngology/Head and Neck Surgery
    Memphis, Tennessee, United States

    • Co-Author(s)

  • MH

    Michael J. Herr, PhD

    Professor of Anatomy
    University of Tennessee College of Medicine Department of Anatomy, USA

  • JG

    John P. Gleysteen, MD

    UTHSC Department of Otolaryngology Head-Neck Surgery, USA

  • ES

    Eugene R. Sansoni, MD

    UTHSC Department of Otolaryngology Head-Neck Surgery, USA

    • Senior Author(s)

  • C. Burton Wood, MD

    Assistant Professor
    UTHSC Department of Otolaryngology Head-Neck Surgery
    Memphis, Tennessee, USA

Disclosure(s):
Natasha D. Tillett, MD: No relevant relationships to disclose.
Stephen F. White, MD: No relevant relationships to disclose.


Introduction: This study is a systematic review of the literature which seeks to estimate toxicity outcomes in response to radiation and/or chemoradiation in patients with HIV and head and neck cancer.

Methods: PubMed, Scopus, Embase, and the Cochrane library databases were used to search for studies published from January 1, 1996, until January 1, 2022, that included toxicity and survival outcomes related to radiotherapy in patients with HIV and head and neck cancer. Key search terms included “head and neck cancer” and “HIV” and “radiation.” Only studies involving more than one human patient were included. PRISMA guidelines were followed for proper study inclusion and data extraction. The primary outcomes assessed were radiation toxicity and overall survival.

Results: 7 studies included adequate survival or toxicity data in patients with HIV and head and neck cancer and were analyzed in this review, with inclusion of 259 patients. Of these patients, 84% were male and relatively young with median age at diagnosis ranging from 39 to 53 years old. There was significant diversity in reporting of toxicity rates and overall survival data amongst the various studies. Pooled weighted average grade 3 mucositis and dermatitis rates were calculated at 19.3% and 22.5% which compare favorably to historical radiation toxicity rates reported in the literature for head and neck cancer in the general population. Pooled estimated overall survival was 73%. Estimated overall survival at 36 months ranged from 62% to 83% across 6 studies.

Conclusions: This review provides support that patients with HIV and head and neck cancer may be treated with standard radiotherapy or chemoradiotherapy dosages without undue toxicity rates. Larger studies with more consistent reporting of toxicity rates, inclusion of seronegative comparison groups, and more consistent inclusion of HPV status are needed to validate these results.