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Hépato-Gastro & Oncologie Digestive

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Epidermoid anal carcinoma and HIV patients Volume 21, issue 4, Avril 2014

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Authors
1 Groupe hospitalier Paris Saint-Joseph, Institut Léopold Bellan, service de proctologie médico-chirurgicale, 185, rue Raymond Losserand, 75014 Paris, France
2 Hôpital européen Georges Pompidou, service de radiothérapie, 20, rue Leblanc, 75015 Paris, France
3 AVVEC, Institut d’oncologie Hartmann, 4, rue Kleber, 92300 Levallois Perret, France
4 Hôpital Européen Georges Pompidou, service d’immunologie clinique, 20, rue Leblanc, 75015 Paris, France
* Tirés à part

Epidermoid anal carcinoma is the 4th most frequent malignant disease reported in patients infected with HIV. The incidence of the disease increases with the duration of immune deficiency associated with HIV. The same treatment is delivered to patients infected with HIV and subjects negative for HIV: fluorouracil-plus mitomycin-based radiochemotherapy. Data on overall survival rate, disease free survival rate and local disease control reported in retrospective comparative studies are not consistent. There is a strong negative impact of increased radiochemotherapy duration, common in this population, partly due to treatment toxicity. The influence of immunity level assessed by CD4 counts on outcome is still under debate. Anyway, it is reasonable to consider adaptation of treatment of carcinoma in patients with CD4 counts above 200 μ/L. Combined anti retroviral therapy should be optimized before initiating radiochemotherapy, as it seems that overall survival rates and disease free survival rates obtained in immunodeficient patients are quite similar to those reported in immunocompetent patients when the treatment planning is respected.