Quando uma mulher grávida é submetida à radioterapia mamária, o feto pode ser gravemente afetado pela dose periférica. Com o objetivo de verificar essa dose, um objeto simulador humanóide foi irradiado na mama esquerda. O phantom é um manequim adaptado, com alguns materiais (de densidades próximas a da água) dentro e fora do mesmo. A irradiação foi feita usando feixes de raios X de energia de 6 MeV, provenientes de um acelerador linear “Clinac 600C”. Durante as irradiações, foi empregada uma blindagem, constituída de blocos e placas de chumbo, em torno da região abdominal do manequim. Além disso, foram utilizados dois tipos de filtros: físico, com angulação de 30o, e dinâmico. Através de uma câmara de ionização cilíndrica posicionada na região fetal do simulador, verificou-se que, ao final do tratamento mamário, a dose de radiação periférica atinge valores entre 3,90 e 48,67 cGy quando se irradia com o filtro físico, e entre 1,75 e 13,78 cGy para o filtro dinâmico; ambos com a blindagem. Através dos dados obtidos, conclui-se que a implantação do filtro físico incrementa a dose periférica devido ao aumento da intensidade da radiação de fuga e ao espalhamento causado pelo material atenuador. Além disso, a blindagem empregada não foi suficiente para bloquear toda radiação secundária: Ao se empregar o filtro em cunha, segundo a literatura, as doses podem ser capazes de induzir o retardo mental e o câncer durante a vida pós-nascimento. Já com o filtro dinâmico esses riscos são reduzidos drasticamente, chegando a ser ínfimos. / When a pregnant woman is submitted to breast radiotherapy, the fetus may be seriously affected by the peripheral dose. In order to verify that dose, a humanoid phantom, was irradiated at the left breast. The phantom is an adapted manikin, with some materials (densities close to water) inside and outside of it. The irradiation was done using a 6 MeV x-ray beam energy from a linear accelerator “Clinac 600C”. During the irradiation, a shield around the abdominal area of the manikin, consisting of blocks and slabs of lead was used. In addition, two types of filters were used: a physical, with 30o angulation, and an enhanced dynamic one. Through a cylindrical ionization chamber, positioned in the simulator ́s fetal region, it was found that, at the end of the breast treatment, the peripheral doses reach values between 3.90 and 48.67 cGy, when the physical wedge was used. With the application of the enhanced dynamic wedge, the values were between 1.75 and 13.78 cGy. According to the obtained data, the physical wedge can increase the peripheral dose due to the larger background radiation intensity and to the scattering caused by the attenuator material. In addition, the shielding couldn ́t block all the secondary radiation, which, according to the literature, can be able to induce mental retardation and cancer during postnatal life. However, the induction to these effects is negligible, when the type of wedge was changed.

Esta pesquisa apresenta e compara medidas de doses pediátricas periféricas em radioterapia, em regiões de tireóide, coração, mama, abdome, medial de ovários e testículos. Tais doses foram obtidas com TLDs de LiF:Mg,Ti (TLD-100) em pó, posicionados em três objetos simuladores humanóides com tamanhos de crianças de dois, cinco e dez anos, feitos de polietileno de alta densidade e completamente preenchidos com água. Foi empregado um acelerador linear Varian Clinac 600CD para irradiar a cabeça dos três objetos simuladores, com feixes de Raios X produzidos com potencial de 6 MV, com três diferentes planejamentos craniais: (a) IMRT sliding window com o colimador multifolhas rotacionado em 0º, (b) IMRT sliding window com o colimador multifolhas rotacionado em 90º e (c) planejamento conformal (3D). As doses aplicadas foram de 300 cGy e 600 cGy com cinco campos coplanares para todos os planejamentos. Como resultado deste trabalho observa-se que as doses obtidas para todas as irradiações são muito baixas, quando comparadas aos valores de doses determinísticas para as regiões de maior interesse em proteção radiológica e que IMRT 90º proporciona maior blindagem para a radiação de fuga que se direcionaria para o corpo do paciente, oferecendo vantagens quando comparado com os planejamentos conformal e IMRT 0º. / This research presents and compares peripheral pediatric doses measurements in radiation therapy, for of thyroid, heart, breast, abdomen, ovaries and testicles regions, obtained with TLD LiF: Mg, Ti (TLD-100) powder, placed on three humanoid phantoms with sizes of children as two, five and ten years old, made of high density polyethylene and completely filled with water. It at linear accelerator Varian Clinac 600CD was employed to irradiate the heads of the three phantoms, with X-rays beams generated by a potential of 6 MV, with three different skull plannings: (a) IMRT sliding window with multileaf collimator rotated 0°, (b) IMRT sliding window with the multileaf collimator rotated 90° and (c) conformal planning (3D). The doses applied were 300 cGy and 600 cGy with five coplanar fields for all cares planning. The results show that the doses obtained for the all irradiations are very low compared to deterministic dose values deterministic for the regions of greater interest in radiological protection and that IMRT 90º provides more shielding for leakage radiation which would be directed to patient's body, offering advantages when compared to conformal planning and IMRT 0º.

Quando uma mulher grávida é submetida à radioterapia mamária, o feto pode ser gravemente afetado pela dose periférica. Com o objetivo de verificar essa dose, um objeto simulador humanóide foi irradiado na mama esquerda. O phantom é um manequim adaptado, com alguns materiais (de densidades próximas a da água) dentro e fora do mesmo. A irradiação foi feita usando feixes de raios X de energia de 6 MeV, provenientes de um acelerador linear “Clinac 600C”. Durante as irradiações, foi empregada uma blindagem, constituída de blocos e placas de chumbo, em torno da região abdominal do manequim. Além disso, foram utilizados dois tipos de filtros: físico, com angulação de 30o, e dinâmico. Através de uma câmara de ionização cilíndrica posicionada na região fetal do simulador, verificou-se que, ao final do tratamento mamário, a dose de radiação periférica atinge valores entre 3,90 e 48,67 cGy quando se irradia com o filtro físico, e entre 1,75 e 13,78 cGy para o filtro dinâmico; ambos com a blindagem. Através dos dados obtidos, conclui-se que a implantação do filtro físico incrementa a dose periférica devido ao aumento da intensidade da radiação de fuga e ao espalhamento causado pelo material atenuador. Além disso, a blindagem empregada não foi suficiente para bloquear toda radiação secundária: Ao se empregar o filtro em cunha, segundo a literatura, as doses podem ser capazes de induzir o retardo mental e o câncer durante a vida pós-nascimento. Já com o filtro dinâmico esses riscos são reduzidos drasticamente, chegando a ser ínfimos. / When a pregnant woman is submitted to breast radiotherapy, the fetus may be seriously affected by the peripheral dose. In order to verify that dose, a humanoid phantom, was irradiated at the left breast. The phantom is an adapted manikin, with some materials (densities close to water) inside and outside of it. The irradiation was done using a 6 MeV x-ray beam energy from a linear accelerator “Clinac 600C”. During the irradiation, a shield around the abdominal area of the manikin, consisting of blocks and slabs of lead was used. In addition, two types of filters were used: a physical, with 30o angulation, and an enhanced dynamic one. Through a cylindrical ionization chamber, positioned in the simulator ́s fetal region, it was found that, at the end of the breast treatment, the peripheral doses reach values between 3.90 and 48.67 cGy, when the physical wedge was used. With the application of the enhanced dynamic wedge, the values were between 1.75 and 13.78 cGy. According to the obtained data, the physical wedge can increase the peripheral dose due to the larger background radiation intensity and to the scattering caused by the attenuator material. In addition, the shielding couldn ́t block all the secondary radiation, which, according to the literature, can be able to induce mental retardation and cancer during postnatal life. However, the induction to these effects is negligible, when the type of wedge was changed.

Made available in DSpace on 2015-04-20T12:31:29Z (GMT). No. of bitstreams: 1 Rodrigo Cesar das Neves Amorim.pdf: 5191612 bytes, checksum: 928eb24ece47b6a34630736ce7c58e0c (MD5) Previous issue date: 2009-09-11 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / Isobrucein B (2) and neosergeolide (5) are quassinoids which are obtained from Picrolemma sprucei. These compounds have proven in vitro antitumor, antimalarial, anthelminthic, cytotoxic, insecticide and leishmanicidal activities. Herein, in vitro techniques were used to investigate a range of biological activities of 2 and 5 and known semi-synthetic derivative 1,12-diacetylisobrucein B (21) and 12-acetylneosergeolide (22). These compounds were evaluated for general toxicity toward the brine shrimp species Artemia franciscana, cytotoxicity toward human tumour cells, larvicidal activity toward the dengue fever mosquito vector Aedes aegypti and antimalarial activity against the human malaria parasite Plasmodium falciparum. 2 and 5 exhibited the greatest antimalarial activity against multidrug-resistant P. falciparum K1 strain. 2 and 5 (LC50 = 3.2-4.4 mg/L) displayed greater lethality than derivative 22 (LC50 = 75.0 mg/L) toward A. aegypti larvae, while derivative 21 was inactive. Biological assays were also performed with extracts and fractions obtained from P. sprucei fruit. A TLC densitometry method was developed to mensurate the quassinoids content in fruits extracts and fractions. This analysis determinate that only chloroform fractions presents significative content of 2 and 5 and this data is related to the biological activities. Infusions of the stems of P. sprucei are used in the Amazon region as antimalarials. They contain 2 and 5. An LC-(+)-ESI-MS/MS method was developed and applied to the determination of 2 and 5 in P. sprucei infusions. The concentrations of 2 and 5 in the stem infusion were found to be 60.1 and 774 μg L-1, respectively / Isobruceína B (2) e a neosergeolida (5) são quassinóides obtidos de Picrolemma sprucei. Essas substâncias possuem atividade antitumoral, antimalárica, anti-helmíntica, citotóxica, inseticida e leishmanicida in vitro já comprovadas. Neste trabalho, técnicas in vitro foram utilizadas para investigar uma variedade de atividades biológicas de 2 e 5 e dos derivados semi-sintéticos 1,12-diacetilisobruceína B (21) e 12-acetilneosergeolida (22). Essas substâncias foram avaliadas quanto à sua toxicidade geral frente a larvas do microcrustáceo Artemia franciscana, citotoxicidade frente a células tumorais humanas em colaboração com o laboratório de Oncologia da UFC, sob coordenação da Profa. Cláudia Pessoa, atividade larvicida frente a larvas do mosquito vetor da dengue Aedes aegypti e atividade antimalárica frente ao parasita causador da malária humana Plasmodium falciparum. 2 e 5 exibiram elevada atividade antimalárica frente à cepa multiresistente de P. falciparum K1 (CI50 1,0-4,0 ng/mL). 2 e 5 (CL50 3,2-4,4 mg/L) apresentaram letalidade bem mais elevada do que o derivado 22 frente a larvas de A. aegypti, ao passo que o derivado 21 se mostrou inativo. Ensaios biológicos também foram realizados com extratos e frações obtidos de frutos de P. sprucei. Um método baseado em CCD-densitometria foi desenvolvido para mensurar o teor de quassinóides nos frutos e frações destes frutos. Essas análises determinaram que apenas as frações obtidas em clorofórmio apresentam teores significativos de 2 e 5 e esses teores estão relacionados às atividades biológicas. Infusões dos caules de P. sprucei são utilizadas na Amazônia . Um método baseado em LC-(+)-ESI-MS/MS foi desenvolvido e aplicado para determinar o teor de 2 e 5 em infusões de P. sprucei. As concentrações de 2 e 5 nas infusões de caules são de 60,1 e 774 μg L-1, respectivamente

The present thesis deals with different aspects of the chemistry and photo-biology of various ferrocene-conjugates, their interaction with double helical DNA, DNA photocleavage and photo-enhanced cytotoxicity in visible light, localization and cellular uptake to study the mechanism of cell death. Phenyl analogues of the active complexes have been synthesized and used for comparison in biological assays. Chapter I presents an overview of cancer and its types, various treatments for cancer. A general overview on the Photodynamic Therapy, a new modality of light activated cancer treatment and its various possible mechanism of action, has been made. The promise of photoactivated chemotherapy is discussed with recently developed metal based antitumor agents. Biological applications of few ferrocene conjugates as anticancer and anti-malarial agents are discussed. The objective of the present investigation is also presented in this chapter. Chapter II presents the synthesis, characterization, structure, DNA binding, DNA photocleavage, photocytotoxicity and cellular localization of ferrocene-conjugated dipicolylamine oxovanadium(IV) complexes of curcumin. To explore the role of the ferrocenyl moiety the phenyl analogue of the ferrocenyl complexes is synthesized and used as a control for comparison purpose. Chapter III deals with the photo-induced DNA cleavage and photo-enhanced cytotoxicity of ferrocene-conjugated oxovanadium(IV) complexes of heterocyclic bases. The synthesis, characterization, structural comparisons, DNA binding, DNA photocleavage and photocytotoxic activity in visible light are discussed in detail. Chapter IV describes the synthesis, characterization and structure of ferrocene-conjugated oxovanadium(IV) complexes of acetylacetonate derivatives. The complexes are evaluated for DNA binding, DNA photocleavage and photocytotoxic activity in HeLa, MCF-7, 3T3 cells in visible light. The fluorescent nature of the complexes is used to study the cellular localization of the complexes and the mechanism of cell death induced by the complexes is also discussed. Chapter V presents the photocytotoxic effect of ferrocene-conjugated oxovanadium(IV) complexes of different curcuminoids in HeLa , HepG2 and 3T3 cells. Curcumin based fluorescence has been successfully used to study the cellular uptake and localization behavior of the complexes. The positive role of the ferrocenyl complex is evident from the ~4 fold increase in its photocytotoxicity compared to the phenyl analogue. The apoptotic mode of cell death is evident from nuclear co-staining using Hoechst dye. Chapter VI describes the synthesis, characterization and photochemotherapeutic efficacy of ferrocene conjugates of N-alkyl pyridinium salts. Mitochondria targeting property of ferrocene compound having n-butyltriphenylphosphonium group has been studied by JC-1 assay. FACS analysis showed significant sub G1/G0 phase cell-cycle arrest in cancer cells on visible light treatment. Finally, the summary of the dissertation and conclusions drawn from the present investigations are presented. The references in the text have been indicated as superscript numbers and compiled at the end of each chapter. The complexes presented in this thesis are represented by bold-faced numbers. Crystallographic data of the structurally characterized complexes are given in CIF format in the enclosed CD (Appendix-I). Due acknowledgements have been made wherever the work described is based on the findings of other investigators. Any unintentional omission that might have happened due to oversight or mistake is regretted. INDEX WORDS: Ferrocene conjugates Crystal structure DNA binding DNA photocleavage Photocytotoxicity Vanadium Cellular Imaging

Au travers d’études cliniques et biologiques, de méta-analyses et de revues systématiques de la littérature, nous avons étudié les CBNPC de stade III sur le plan thérapeutique et cherché des facteurs pronostiques pour la survie dans le but d’améliorer la classification internationale et, à terme, de permettre une meilleure prise en charge des patients inclus dans ce groupe hétérogène de tumeurs.<p>Dans le cadre d’essais randomisés, nous avons montré qu’un abord multimodal et multidisciplinaire permettait d’améliorer le pronostic des patients atteints d’un CBNPC de stade III. Le traitement des tumeurs non résécables implique une combinaison de chimiothérapie et de radiothérapie, dont l’administration concomitante doit être proposée aux patients aptes à la tolérer. La chimiothérapie doit être incluse dans le schéma thérapeutique des tumeurs potentiellement résécables. Elle permet une résection chirurgicale complète chez des patients sélectionnés dont la tumeur était initialement non résécable.<p>Nous avons déterminé que des caractéristiques cliniques (l’indice de performance et l’âge), biologiques (les taux sanguins de polynucléaires neutrophiles, d’hémoglobine et de plaquettes, la bilirubinémie) et propres à la tumeur (l’extension locale [T3-4] et ganglionnaire [N3]) avaient une valeur pronostique indépendante pour la survie. Ceci nous a permis d’aboutir à une proposition de modification de la classification internationale concernant les CBNPC de stade III.<p>Bien que pris individuellement, les facteurs biologiques que nous avons étudiés (p53, EGF-R, TTF-1, Mdm2) n’aient pas de valeur pronostique pour la survie, nous avons montré que la combinaison EGF-R+/TTF1- était un facteur pronostique indépendant en analyse multivariée pour la survie spécifique au cancer bronchique.<p>Nous avons finalement évalué le rôle pronostique de la tomodensitométrie par émission de positrons et de la mesure semi-quantitative de captation du 18F-FDG (SUV) sur la survie des patients atteints de CBNPC et montré qu’un SUV élevé était un facteur de mauvais pronostic pour la survie. / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

the majority of patients with early breast cancer receive some form of systemic adjuvant therapy (chemo-, endocrine, and/or targeted therapy). Despite the increase in adjuvant therapy prescription, little progress has been made with respect to assisting oncologists to determine which breast cancer patients, particularly those deemed at “lower risk” of relapse, require chemotherapy or other systemic therapy and which women can safely be treated with loco-regional treatment alone. For these reasons, the identification of prognostic and predictive markers that will assist the clinician in selecting the most suitable form of medical therapy has become very high priority as well as a real challenge in translational research. <p>\ / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

One of the major impediments in the development of marine natural products is the provision of biologically active natural products in sufficient quantity for complete pharmacological evaluation, clinical trials and eventual commercial production. Marine microorganisms show great promise in providing a renewable source of biologically active natural products. The main aim of this study was to develop and evaluate methods for the isolation, identification and cultivation of marine fungi from the South African marine environment for the production of biologically active secondary metabolites. Twenty-four species of fungi were isolated from marine algae collected from the intertidal zone near Port Alfred, South Africa. The fungi were cultivated in small-scale under static and agitated conditions and their crude intra- and extracellular organic extracts were screened by ¹H NMR and a series of bioassays. Using this as a basis, one isolate was selected for further study. By analyses of the lTS1 region of the ribosomal DNA, the fungal isolate was identified as a marine-derived isolate of Eurotium rubrum (Aspergillus ruber). Although E. rubrum has been isolated from the marine environment, no investigations have been undertaken to determine the adaptation of these isolates to the marine environment. In order to optimise productivity, creativity and incubation time, the fungus was cultivated in small-scale using a variety of carbon (glucose, fructose, lactose, sucrose, marmitol and maltose) and nitrogen sources (ammonium tartrate, urea, peptone and yeast extract). An HPLC-DAD method was developed to assess the metabolic creativity and productivity under different fermentation conditions. Distinctive variations in the range and yield of metabolites produced as well as morphology and growth time were observed. The crude extracts from all fermentations were combined and six known compounds were isolated by reversed-phase chromatography and their structures elucidated by spectroscopic techniques. The known compounds were fIavoglaucin, aspergin, isodihydroauroglaucin, isotetrahydroauroglaucin, neoechinuline A and physcion. Neoechinuline A, isodihydroauroglaucin and isotetrahydroauroglaucin showed activity against oesophageal and cervical cancer cell lines.

Deux approches potentiellement anti-tumorales, employant des nanoparticules magnétiques (NPMs) et des champs magnétiques oscillants, furent étudiées. La première, l’hyperthermie magnétique, utilise l’échauffement de NPMs au contact des cellules tumorales provoqué par un champ magnétique alternatif haute-fréquence. Durant cette thèse, il fut démontré que les forces magnéto-mécaniques induites par les inhomogénéités de champ magnétique pendant un essai d’hyperthermie magnétique n’avaient aucune influence sur la viabilité cellulaire. Egalement, des mesures magnétiques, d’XPS, et de puissance de chauffe de NPMs de fer enrobées d’une coquille de silice amorphe furent effectuées et analysées. Il fut observé que cette coquille permettait de préserver les propriétés magnétiques des NPMs suite à l’exposition à un environnement aqueux. La deuxième approche anti-tumorale utilise des NPMs soumises à un champ magnétique basse-fréquence, induisant une stimulation mécanique des cellules tumorales. Une étude théorique complète de l’influence du champ magnétique, de l’agitation thermique et des interactions magnétiques sur la force magnéto-mécanique exercée par des NPMs, fut effectuée. Elle démontra notamment que cette force augmente de manière drastique pour une assemblée de NPMs lorsque la rotation du champ magnétique induit une rupture de symétrie dans l’évolution temporelle du couple magnéto-mécanique. Expérimentalement, il fut développé différents prototypes de génération de champ magnétique tournant à basse fréquence. Des tests in vitro furent réalisés en utilisant des NPMs enrobées par une matrice de phosphatidylcholine, leur permettant d’être solidaires des membranes cellulaires. Suite à la rotation d’un champ magnétique de 40 ou 380 mT, à 10 Hz, il fut observé une réduction de la survie cellulaire. / Two anti-tumor treatments based on magnetic nanoparticles (MNPs) and oscillating magnetic field were studied. The first one, magnetic hyperthermia, uses the heat released by MNPs in contact with tumor cells under a high frequency alternating magnetic field. We have shown that the forces induced by magnetic field inhomogeneity during magnetic hyperthermia essay no influence on cellular viability. Moreover, magnetic measurements, XPS characterization and heating power evaluation of iron MNPs coated by amorphous silica shell were carried out. It was observed that this shell is able to preserve the MNP magnetic properties submitted to an aqueous environment. The second anti-tumor treatment combines MNPs and low-frequency magnetic field, inducing mechanical stress to tumor cells. A complete theoretical study on the influence of magnetic field, thermal agitation and magnetic interaction on the magneto-mechanical forces generated by the MNPs was carried out. It was demonstrated that for a MNP assembly this force increases dramatically when the rotation of the magnetic field induces a break of time reversal symmetry on the magneto-mechanical torque. Experimentally, several devices generating low frequency rotating magnetic fields were developed. Using these devices, in-vitro essays were also achieved using phosphatidylcholine coated MNPs, which bind to cellular membranes. An application of a 40 or 380 mT magnetic field rotating at 10 Hz reduced cell survival rate.

It is estimated that 6742 South African women are diagnosed with cervical cancer and 3681 women die from the disease every year. In 1993, The Centers for Disease Control declared cervical cancer an Acquired Immunodeficiency Syndrome defining illness. Apart from persistent human papillomavirus infection, HIV infection is the most common co-factor contributing to cervical cancer in South Africa. Studies have noted that in HIV positive women, there has been an occurrence of faster progression to more advanced stages of cervical cancer with high cases of treatment failure and recurrence. There is limited literature available regarding the prognosis of HIV positive women who suffer from cervical cancer. Women who are HIV positive and have cervical cancer have not been evaluated in detail regarding their response and adherence to cervical cancer treatment. Standard treatment protocols for this set of patients have not been defined. The aim of this study was to assess how HIV positive women who have been diagnosed with cervical cancer responded and adhered to cervical cancer therapy which includes: curative radiotherapy; curative chemotherapy; concurrent chemoradiation or palliative radiotherapy. The study also evaluated the effects of the concurrent use of antiretrovirals and cervical cancer treatment. This was done to determine whether invasive cervical cancer in women who were HIV positive could be managed using the same treatment protocols as patients who were HIV negative. A historical cohort design was employed for the study. The study was conducted at the Oncology Department of a tertiary level hospital located in the Eastern Cape Province, South Africa. The total sample consisted of 196 medical records of women diagnosed with cervical cancer between 2005 and 2008. One hundred women were HIV negative, 83 were HIV positive and the HIV status of 13 women could not be determined. The records were audited over a period of two years from the date of diagnosis. The term „complete response‟ referred to patients who had no recurrence of cervical cancer and no evidence of metastases after undergoing treatment. At one month following treatment there was a significant difference in the incidence of complete response between the HIV positive patients and the HIV negative patients (Chi2 = 16.4, d.f. = 1, p = 0.00005, Cramer‟s V = 0.31). The significant difference in response to treatment between the HIV positive patients and the HIV negative patients was maintained at six months after treatment (Chi2 = 15, d.f. = 1, p = 0.00011, Cramer‟s V = 0.34), 12 months after treatment (Chi2 = 20.5, d.f. = 1, p = 0.00001, Cramer‟s V = 0.37), 18 months after treatment (Chi2 = 9.8, d.f. = 1, p = 0.00173, Cramer‟s V = 0.28) and 24 months after treatment (Chi2 = 5.0, d.f. = 1, p = 0.02571, Cramer‟s V = 0.26). At each of these intervals, cases of treatment failure and metastases were significantly higher in the HIV positive women than in the HIV negative women. Although there was no significant difference in the incidence of adherence between the HIV negative women, the HIV positive women who were on HAART and the HIV positive women who were not on HAART, there was a significant difference in the incidence of the various reasons for non adherence between the various groups. These reasons included: missed scheduled appointments (Chi2 = 2.9, d.f. = 2, p = 0.02385, Cramer‟s V = 0.31); low blood count (Chi2 = 4.0, d.f. = 2, p = 0.01327, Cramer‟s V = 0.15); radiotherapy induced skin breakdown (Chi2 = 0.6, d.f. = 2, p = 0.04581, Cramer‟s V = 0.16) and radiotherapy induced diarrhoea (Chi2 = 6.9, d.f. = 2, p = 0.03118, Cramer‟s V = 0.19). According to the 2004 National Antiretroviral Treatment Guidelines, cervical cancer patients would fall into the WHO stage IV category of HIV disease thus all patients with confirmed diagnosis of invasive cervical cancer should be commenced on antiretrovirals as soon as the cancer diagnosis is made regardless of their CD4 count. However, in the current study, 13 percent (n= 83) of the HIV positive women were not on antiretrovirals. The study concluded that HIV positive women had a higher incidence of both treatment failure and metastases to cervical cancer treatment. Standard radiotherapy and concurrent chemoradiation cervical cancer treatment protocols should be still be used in both HIV negative patients and HIV positive patients so as not to compromise tumour control. Furthermore, in accordance with the antiretroviral treatment guidelines, all HIV positive patients with cervical cancer should receive antiretrovirals irrespective of their CD4 count.