A case of esophageal cancer with human immunodeficiency virus infection that progressed rapidly after neoadjuvant chemoradiotherapy

• Published in: Clinical journal of gastroenterology Vol. 13; no. 1; pp. 17 - 21
• Main Authors: Hayakawa, Yuka, Kobayashi, Katsumasa, Sakamoto, Naoya, Matsuoka, Mana, Nozaka, Takahito, Misumi, Yoshitsugu, Matsumoto, Taichi, Miura, Natsuki, Furumoto, Yohei, Asano, Toru, Horiuchi, Takao, Fujiki, Kazuhiko
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.02.2020
• Subjects: Abdominal Surgery; Case Report; Colorectal Surgery; Gastroenterology; Hepatology; Medicine; Medicine & Public Health; Surgical Oncology; Non-AIDS-defining malignancies; Chemoradiotherapy; HIV infection; Esophageal cancer; Antiretroviral therapy
• ISSN: 1865-7257; 1865-7265
• DOI: 10.1007/s12328-019-01028-z

While antiretroviral therapy has improved mortality in patients with human immunodeficiency virus (HIV) infections, deaths caused by non-acquired immunodeficiency syndrome-defining malignancies are increasing. A woman in her 70s with HIV infection who was receiving antiretroviral therapy presented with dysphagia. She was diagnosed with esophageal cancer (cT3N2M0, stage III). She received neoadjuvant chemotherapy (cisplatin and 5-fluorouracil) and radiotherapy. During treatment, we continued administering antiretroviral therapy and prophylaxis for opportunistic infections, with due attention to side effects and drug–drug interactions. No severe adverse events occurred. The primary lesion and metastatic lymph nodes decreased in size after treatment; however, 1 month later, her cancer spread to other organs; thus, surgery was canceled. Her general condition rapidly worsened. She eventually died of cancer cachexia and aspiration pneumonia. No previous reports have mentioned the treatment plan and management of esophageal cancer in HIV-positive patients. This report presents a case of esophageal cancer with HIV infection that progressed rapidly after neoadjuvant chemoradiotherapy.