• Filippo Alongi, Niccolò Giaj-Levra, Savino Sciascia, Alessandra Fozza, Sergio Fersino, Alba Fiorentino, Rosario Mazzola, Francesco Ricchetti, Michela Buglione, Dora Buonfrate, Dario Roccatello, Umberto Ricardi, and Zeno Bisoffi.
• Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy; University of Brescia, Brescia, Italy.
• Lancet Oncol. 2017 Jul 1; 18 (7): e379-e393.

AbstractAlthough 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.Copyright © 2017 Elsevier Ltd. All rights reserved.

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