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Abstract

Although the introduction of highly active antiretroviral therapy has radically improved the life expectancy of patients with HIV, HIV positivity is still considered a major barrier to oncological treatment for patients with cancer because of their worse prognosis and increased susceptibility to toxic effects compared with patients who are immunocompetent. The use of radiotherapy with or without chemotherapy, immunotherapy, or molecular targeted therapy is the standard of care for several cancers. These new drugs and substantial improvements in radiotherapy techniques, including intensity-modulated radiotherapy, image-guided radiotherapy, and stereotactic ablative radiotherapy, are optimising the feasibility of such anticancer treatments and are providing new opportunities for patients with cancer and HIV. In this Review, we discuss the role of radiotherapy, with or without chemotherapy or new drugs, in the treatment of cancer in patients with HIV, with a focus on the efficacy and tolerability of this approach on the basis of available evidence. Moreover, we analyse and discuss the biological basis of interactions between HIV and radiotherapy, evidence from preclinical studies, and immunomodulation by radiotherapy in the HIV setting. 

Author information

Alongi F1, Giaj-Levra N2, Sciascia S3, Fozza A4, Fersino S5, Fiorentino A5, Mazzola R5, Ricchetti F5, Buglione M6, Buonfrate D7, Roccatello D3, Ricardi U8, Bisoffi Z7.

1Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy; University of Brescia, Brescia, Italy.2Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy; Department of Oncology, University of Turin, Torino, Italy. Electronic address: niccolo.giajlevra@sacrocuore.it.3Department of Clinical and Biological Sciences, Centre of Research of Immunopathology and Rare Diseases-Coordinating Centre of Piemonte and Valle d'Aosta Network for Rare Disease, Torino, Italy.4Radiation Oncology, Department of Oncology, Ospedale dell'Angelo, Mestre-Venezia, Italy.5Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy.6Radiation Oncology, University and Spedali Civili, Brescia, Italy.7Centre for Tropical Diseases, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy.8Department of Oncology, University of Turin, Torino, Italy.