肺癌是感染艾滋病毒（PLWH）人群中最常见的非艾滋病定义的癌症，但是关于放疗和包括免疫治疗在内的全身方案的疗效和毒性的数据不足。为了回答这个问题，我们在 Ovid Medline 上进行了系统文献搜索，直到 2022 年 3 月 17 日。我们包括了 21 篇文献，共招募了 513 名 NSCLC 患者，其中男性（75-100%），（前）吸烟者（75-100%），且在诊断时处于 III-IV 期（65-100%）。化疗的整体反应率（ORR）（n = 186）患者高度可变（17％-83％），并伴有严重的血液毒性。单一免疫治疗的 ORR 在 13％ 至 50％ 之间（n = 68），几乎都使用白金类方案，中位总生存期在 9 至 11 个月之间，毒性相当可接受，与 HIV 非感染人群的研究结果一致。所有 5 名使用酪氨酸激酶抑制剂（TKI，吉非替尼或厄洛替尼）的患者都显示出部分反应和长期生存。然而，应避免将 TKI 与抗逆转录病毒治疗结合使用，如利托那韦等药物。 评估了 42 名患者的放疗，显示ORR 高（55％-100％），但 18％ 的患者出现肺炎。 医学数据表明，在控制感染的 PLWH 中，放疗和全身治疗是有效且安全的。然而，大多数报告都很少见且不一致。与此同时，需要进行更大规模的研究以验证这些令人鼓舞的发现。此外，临床试验不应限制 PLWH 的纳入，因为该人群需要更多有关治疗长期疗效和安全性的数据，特别是免疫治疗。版权所有©2023。由Elsevier B.V.出版。

Lung cancer is the most common non-AIDS defining cancer among people living with HIV (PLWH), but there is a paucity of data regarding the efficacy and toxicity of radiotherapy and systemic regimens, including immunotherapy, in the treatment of these patients. In order to answer this question, we have performed a systematic search of the literature in Ovid Medline until March 17, 2022. We included 21 publications, enrolling 513 PLWH with non-small cell lung cancer (NSCLC), mostly male (75-100%), (ex-)smokers (75-100%) and with stage III-IV at diagnosis (65-100%). The overall response rate (ORR) to chemotherapy (n = 186 patients, mostly receiving platinum-based regimens) was highly variable (17 %-83 %), with a substantial hematological toxicity. ORR varied between 13 % and 50 % with single-agent immunotherapy (n = 68), with median overall survival between 9 and 11 months and a very acceptable toxicity profile, in line with studies in the HIV non-infected population. All five patients receiving tyrosine kinase inhibitors (TKIs; gefitinib or erlotinib) showed a partial response and long overall survival. Yet, combination of TKIs with antiretroviral therapy using pharmacological boosters, such as ritonavir, should be avoided. Radiotherapy was evaluated among 42 patients, showing high ORR (55 %-100 %), but 18 % of patients had a pneumonitis. This systematic review shows that radiotherapy and systemic therapy are effective and safe among PLWH with controlled infection diagnosed with NSCLC. Nonetheless, most reports were small and heterogeneous and larger studies are needed to confirm these encouraging findings. Moreover, clinical trials should not restrict the inclusion of PLWH, as more data is needed regarding the long-term efficacy and safety of treatments among this underserved population, especially of immunotherapy.Copyright © 2023. Published by Elsevier B.V.