Response to Treatment for Prostate Cancer in Patients with Human Immunodeficiency Virus

Abstract

To examine the clinicopathological characteristics and the outcome of HIV-infected patients treated for prostate cancer. We performed a retrospective chart review of all patients with prostate cancer treated at the Brooklyn Veterans Administration Medical Center. We recorded the immunological status at diagnosis, pathological data, treatment parameters, acute treatment-related toxicity, late treatment related toxicity, and biochemical failure. 16 prostate cancer patients treated between 1992 and 2008 were HIV-positive. Median age at diagnosis was 59 years. Median follow-up was 39 months. Ten patients were on highly active antiretroviral therapy (HAART) at prostate cancer diagnosis. Median CD4 count for all patients was 419. Median Gleason Score was 7. Median prostate-specific antigen was 6.3 ng/ml. Sixteen patients were treated with radiotherapy. 5-yr biochemical progression-free survival was 83%. Most patients experienced some gastrointestinal (GI) or genitourinary (GU) toxicity. In only five cases was acute GU toxicity clinically significant (grade ≥ 2). Four patients experienced clinically significant GI toxicity (grade ≥ 2). One of these patients developed late grade 3 GI toxicity. Five patients experienced clinically significant (grade ≥ 2) GU or GI late toxicity. In four of these patients late toxicity was limited to grade 2 GU symptoms. Prostate cancer therapy was well-tolerated in HIV-positive patients.