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Abstract
Objectif. Le but était de faire le point sur la particularité de la prise en charge des personnes souffrant de cancer et séropositifs au VIH Patients et méthode. Il s’agissait d’une étude rétrospective au service de radiothérapie de l’hôpital du Mali sur des patients atteints de cancer durant une période allant de janvier 2016 à décembre 2019. Résultats. Dix patients ont été inclus dans l’étude. L’âge médian était de 42,50 ans. Le cancer du col de l’utérus représentait 90%, et était classé selon FIGO 2009 en stade IVA 10% (n=1), IIIB dans 60% (n=6), et IIA2 dans 20% (n=2). Le Lymphome Hodgkinien scléro-nodulaire représentait 10% (n=1) des cas et était classé favorable selon d’Ann Arbor au stade IIIB. La médiane de CD4 nadir était de 265 cellules/ mm3 (116 – 683). Les patients étaient sous traitement antirétroviral au moment du diagnostic du cancer. Le cancer du col utérin a été traité par radiothérapie à la dose de 70 Gy en raison de 5 séances de 2 Gy par semaine, associée à la chimiothérapie concomitante à base de cisplatine 40 mg/m2/semaine. Le Lymphome Hodgkinien a reçu la radiothérapie à la dose de 30 Gy en 5 séances de 2Gy par semaine sur les sites initialement envahis. Conclusion. Notre étude confirme que l’infection par le VIH est associée à une augmentation du risque de survenue de cancers. La radiothérapie des patientes séropositives pour le VIH ne diffère pas de celle de la population générale.
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References
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References
. WHO.WHO AIDS Epidemic Report 09, 2009 data. unaids.org/ .../ report / 2009 / jc1700_epi_update_2. Consulté le 22 Juillet 2013. Google Scholar
. Centers for Disease Control and Prevention. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR 1992; 41: 1 - 19.
. Ancelle-Park R. Expanded European AIDS case definition. Lancet 1993; 341: 441.
. Lanoy E, Spano JP, Bonnet F, et coll. The spectrum of malignancies in HIV-infected patients in 2006 in France: the ONCOVIH study. Int J Cancer 2011;129:467 - 75.
. Stein L, Urban MI, O’Connell D, et coll. The spectrum of human immunodeficiency virusassociated cancers in a South African black population: results from a case-control study, 1995– 2004. Int J Cancer 2008; 122: 2260 - 5.
. Vale C. Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: a systematic review and meta-analysis of individual patient data from 18 randomized trials. J Clin Oncol. 2008; 26 (35): 5802 - 12
. Malfetano J. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med 1999; 340: 1144.
. Engert A, Plutschow A, Eich HT, et coll. Reduced treatment intensity in patients with early-stage Hodgkin’s lymphoma. N Engl J Med. 2010; 363: 640 - 652.
. Antoine Jaquet, Michael Odutola, Didier K Ekouevi, et coll. Cancer and HIV infection in referral hospitals from four West African countries, Cancer Epidemiology (2015), http://dx.doi.org/10.1016/j.canep.2015.09.002
. Mohamad Nasir S, Nazimah I, Rushdan MN. The Role of Computed Tomography (CT) Scan in Assessment of the Parametrial Involvement in Early Stage Cervical Carcinoma. Journal of Surgical Academia 2012; 2(1): 14.
. Barillot I, Haie-Méder C, Charra Brunaud C, et coll. Radiothérapie des cancers du col et de l’endomètre. Cancer Radiother 2016; 20: S189 - 95.
. Herida M, Mary-Krause M, Kaphan R, et coll. Incidence of non-AIDS-defining cancers before and during the highly active antiretroviral therapy era in a cohort of human immunodeficiency virus-infected patients. J Clin Oncol 2003; 21: 3447 - 53.
. Frisch M, Biggar RJ, Engels EA, et coll. Association of cancer with AIDS-related immunosuppression in adults. JAMA 2001; 285: 1736 - 45.
. Hoffman R, Welton ML, Klencke B, et coll. The significance of pre-
treatment CD4 count on the outcome and treatment tolerance of HIV-positive patients with anal cancer. Int J Radiat Oncol Biol Phys 1999; 44: 127 - 31.
Vale C. Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: a systematic review and meta-analysis of individual patient data from 18 randomized trials. J Clin Oncol. 2008; 26 (35): 5802 - 12.
. Xicoy B, Miralles P, Morgades M, Rubio R, et coll. Long-term follow up of patients with human immunodeficiency virus infection and advanced stage Hodgkin’s lymphoma treated with doxorubicin, bleomycin, vinblastine and dacarbazine. Haematologica 2013; 98: e85 - 6.
. Montoto S, Shaw K, Okosun J, et coll. HIV status does not influence outcome in patients with classical Hodgkin lymphoma treated with chemotherapy using doxorubicin, bleomycin, vinblastine, and dacarbazine in the highly active antiretroviral therapy era. J Clin Oncol 2012; 30: 4111- 6.
. Molinier V, Huguet F, Ballester M, et coll. Outcomes after radiation therapy for HIV positive patients with invasive cervical cancer. Cancer Clin Oncol 2018; 7: 12 - 21.