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Radiation Therapy for HIV-Associated Diffuse Large Cell Non-Hodgkin Lymphoma

Radiation Oncology, Zurich University Hospital, University of Zurich, Zurich, Switzerland, sacha.rothschild{at}dkf.unibe.ch

Mathias Dolder, MD

Radiation Oncology, Zurich University Hospital, University of Zurich, Zurich, Switzerland

Burkhardt Seifert, PhD

Biostatistics, Institute for Social and Preventive Medicine, University of Zurich, Zurich, Switzerland

Urs M. Lütolf, MD

Radiation Oncology, Zurich University Hospital, University of Zurich, Zurich, Switzerland

I. Frank Ciernik, MD

Center for Clinical Research, Zurich University Hospital, University of Zurich, Zurich, Switzerland

Purpose. To report the clinical experience with external beam radiotherapy (RT) for AIDS-related lymphoma (ARL) with or without the involvement of the central nervous system (CNS) in HIV-infected patients. Patients and Methods. Clinical outcome of 24 HIV-seropositive patients with ARL treated with RT from 1995 to 2004 was reviewed, testing factors associated with outcome. Results. After 1 and 5 years, the overall survival was 65% and 35%, respectively. The mean RT dose was 31 Gy after normalization to fractions of daily 2 Gy (range, 7.8-47.2 Gy). Radiotherapy dose was associated with survival in univariate (P = .04) and multivariate analysis (P = .01). Other factors in univariate analysis associated with outcome were viral load (VL), highly active antiretroviral therapy (HAART), ARL stage, and CNS involvement. Patients with CNS involvement achieved complete response in 46% and improved clinical performance was seen in 73%. Conclusions. After chemotherapy, RT in combination with HAART is highly active, and RT should be encouraged especially after suboptimal responses to induction treatment.

Key Words: non-Hodgkin lymphoma • HIV • AIDS • PCNSL • radiation dose

This version was published on July 1, 2009

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 8, No. 4, 239-248 (2009)
DOI: 10.1177/1545109709340439


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