BACKGROUND: Chemo-radiotherapy-induced carotid stenosis and cerebrovascular events in head and neck cancer patients can cause severe disability and death. We aimed to estimate the risk of stroke in such patients over a six-year follow-up period. PATIENTS AND METHODS: The study cohort consisted of head and neck cancer patients (n=10,172). Cox proportional hazard model was used to compare the stroke-free survival rate between the patients treated with radiotherapy or chemotherapy, surgery alone, and surgery with adjuvant therapy after adjusting for possible confounding factors. RESULTS: At the end of follow-up, 384 patients had strokes: 126 (4.3%) from the surgery alone group, 167 (3.8%) from the radiotherapy or chemotherapy group, and 91 (3.2%) from the surgery with adjuvant therapy (P=0.222). Head and neck cancer patients aged less than 55 years treated with radiotherapy or chemotherapy conferred a 1.8-fold higher risk for stroke (95% CI, 1.22-2.56; P=0.003) after adjusting for patient characteristics, co-morbidities, geographic region, urbanization level, and socio-economic status. There was no statistical difference in stroke risk between different treatment modalities in head and neck cancer patients aged 55 years and more. CONCLUSIONS: Young head and neck cancer patients treated with radiotherapy or chemotherapy have higher risks for stroke. Different treatment strategies should be considered in such patients.
BACKGROUND: Chemo-radiotherapy-induced carotid stenosis and cerebrovascular events in head and neck cancerpatients can cause severe disability and death. We aimed to estimate the risk of stroke in such patients over a six-year follow-up period. PATIENTS AND METHODS: The study cohort consisted of head and neck cancerpatients (n=10,172). Cox proportional hazard model was used to compare the stroke-free survival rate between the patients treated with radiotherapy or chemotherapy, surgery alone, and surgery with adjuvant therapy after adjusting for possible confounding factors. RESULTS: At the end of follow-up, 384 patients had strokes: 126 (4.3%) from the surgery alone group, 167 (3.8%) from the radiotherapy or chemotherapy group, and 91 (3.2%) from the surgery with adjuvant therapy (P=0.222). Head and neck cancerpatients aged less than 55 years treated with radiotherapy or chemotherapy conferred a 1.8-fold higher risk for stroke (95% CI, 1.22-2.56; P=0.003) after adjusting for patient characteristics, co-morbidities, geographic region, urbanization level, and socio-economic status. There was no statistical difference in stroke risk between different treatment modalities in head and neck cancerpatients aged 55 years and more. CONCLUSIONS: Young head and neck cancerpatients treated with radiotherapy or chemotherapy have higher risks for stroke. Different treatment strategies should be considered in such patients.
Authors: David J Carpenter; Yvonne M Mowery; Gloria Broadwater; Anna Rodrigues; Amy J Wisdom; Jennifer A Dorth; Pretesh R Patel; Cynthia K Shortell; Robert Clough; David M Brizel Journal: Oral Oncol Date: 2018-03-14 Impact factor: 5.337
Authors: Verónica Fernández-Alvarez; Fernando López; Carlos Suárez; Primoz Strojan; Avraham Eisbruch; Carl E Silver; William M Mendenhall; Johannes A Langendijk; Alessandra Rinaldo; Anne W M Lee; Jonathan J Beitler; Robert Smee; Javier Alvarez; Alfio Ferlito Journal: Strahlenther Onkol Date: 2018-04-20 Impact factor: 3.621
Authors: K Garcez; C C Lim; P Whitehurst; D Thomson; K F Ho; M Lowe; A Sykes; L W Lee; B Yap; N Slevin Journal: Br J Radiol Date: 2014-02-17 Impact factor: 3.039