Vertebral artery stenosis predicts cerebrovascular diseases following radiotherapy for nasopharyngeal carcinoma

Yeh, Ching-Fa; Chin, Yu‐Ching; Hung, Wei; Huang, Pin I.; Lan, Ming‐Ying

doi:10.1007/s00520-022-07011-8

Cited by 4 publications

(4 citation statements)

References 27 publications

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“…A total of 146 studies were ultimately included in our meta‐analysis 9,24–167 . A PRISMA diagram outlining our search is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Vascular events in patients with head and neck cancer: A systematic review and meta‐analysis

Monaghan,

Duckett,

Nguyen

et al. 2024

Head & Neck

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ObjectiveTo assess the incidence of vascular events in patients with head and neck cancer.Review MethodsPrimary studies identified through April 2023. Meta‐analysis was performed.ResultsThere were 146 studies included in the systematic review. Rates of events were collected in the overall group, those with chemoprophylaxis, and those that underwent surgery, radiation, or chemotherapy. Of 1 184 160 patients, 4.3% had a vascular event. Radiation therapy had highest risk of overall events and stroke when compared to surgery and chemotherapy. Chemotherapy had a higher risk of stroke and overall events when compared to surgery.ConclusionsVascular events occur in 4%–5% of patients with head and neck cancer. Our data does not support the use of routine anticoagulation. Patients undergoing radiation therapy had the highest frequency of events.

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“…A total of 146 studies were ultimately included in our meta‐analysis 9,24–167 . A PRISMA diagram outlining our search is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Vascular events in patients with head and neck cancer: A systematic review and meta‐analysis

Monaghan,

Duckett,

Nguyen

et al. 2024

Head & Neck

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“…A previous study indicated that NPC patients with VAS were at a significantly increased risk of IS after RT. 21 Furthermore, we determined that the non-NPC group was particularly vulnerable to experiencing an IS following VAS after RT, in contrast to the NPC group. A study reported that the incidence of VAS after RT was approximately 34.7% in patients with HNC.…”

Section: Discussionmentioning

confidence: 99%

“…20 Compared with CAS, vertebral artery stenosis (VAS) after RT has received less clinical attention. 21 According to a study utilizing magnetic resonance angiography (MRA), the incidence of VAS could reach 34.7% in patients with HNC after RT. 22 With advancements in RT, the radiation doses delivered to the vertebral artery can be markedly reduced.…”

Section: Introductionmentioning

confidence: 99%

Vertebral and Carotid Artery Stenosis after Irradiation Both Raise Ischemic Stroke Risk in Head and Neck Cancer Patients

Jiang,

Chang,

Huang

et al. 2024

Preprint

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Purpose: To study the risk of ischemic stroke (IS) following carotid (CAS) or vertebral artery stenosis (VAS) in head and neck cancer (HNC) patients after radiation therapy (RT). Methods: We included HNC patients who received RT between 2010 and 2023. They underwent regular head and neck imaging monitoring to evaluate cancer recurrence at the department of radiation-oncology and vascular examinations at the department of neurology. Patients were initially divided into nasopharyngeal carcinoma (NPC) and non-NPC groups. The primary outcome was the occurrence of IS after RT, and the secondary outcomes included the development of >50% CAS or >50% VAS after RT. Cox regression and Kaplan?Meier analyses were conducted to compare the outcomes of the study groups. Further analysis was conducted based on the presence or absence of >50% CAS or >50% VAS during the follow-up period. Results: Of the 1,423 HNC patients, 19%, 6.8%, and 2.3% developed >50% CAS, >50% VAS, and IS during a 58-month follow-up. Compared with the NPC group, the non-NPC group exhibited a higher incidence of >50% CAS (25.4% vs. 10.7%, p<0.001) and >50% VAS (8.8% vs. 4.3%, p<0.001), but similar risks of IS. In patients with HNC, >50% CAS (adjusted hazard ratio [HR]=3.21, 95% confidence interval [CI]=1.53-6.71), and >50% VAS (adjusted HR=2.89, 95% CI=1.28-6.53) were both the independent predictors of IS. In the patients with NPC, >50% CAS was an independent predictor of anterior circulation IS (adjusted HR=4.39, 95% CI=1.17-16.47). By contrast, >50% VAS emerged as a predictor of posterior circulation IS in both the NPC (adjusted HR=15.02, 95% CI=3.76-60.06) and non-NPC groups (adjusted HR=13.59, 95% CI=2.21-83.46). Conclusion: HNC patients with >50% CAS or >50% VAS after RT had an increased risk of IS within their corresponding vascular territory. CAS is a major predictor of IS in NPC patients, whereas VAS is a major predictor of IS in both NPC and non-NPC patients.

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“…The frequency of other non-cancer related causes of death changed over time, with cerebrovascular diseases, infectious diseases, COPD and allied conditions becoming more frequent as time passed after NPC diagnosis. Radiotherapy for NPC patients may cause cerebrovascular diseases including transient ischemic attack and ischemic stroke, which can lead to severe disability ( 21 ). Besides, intracranial aneurysms are a rare complication of radiotherapy, but irradiated NPC patients had higher morbidity and mortality rates after aneurysm rupture and a higher angiographic recurrence rate after treatment ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Cause of death during nasopharyngeal carcinoma survivorship: a population-based analysis

Zhou,

Jiang,

et al. 2023

Front. Oncol.

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BackgroundRecently, the survival rate of nasopharyngeal carcinoma (NPC) patients has improved greatly due to developments in NPC treatments. But cause-specific mortality in NPC patients remains unclear. This study aims to investigate the common causes of death in NPC patients.MethodsEligible patients with NPC were included from the Surveillance, Epidemiology, and End Results (SEER) database. Standardized mortality ratios(SMRs) were calculated to compare death rates in NPC patients with those in the general population.ResultsA total of 3475 patients with NPC were included, of whom 1696 patients died during the follow-up period. 52.83% of deaths were caused by NPC, followed by other cancers (28.13%) and non-cancer causes (18.46%). The proportion of patients who died of NPC decreased over survival time. Moreover, non-cancer causes of death increase from 12.94% to 51.22% over time after 10 years of diagnosis. Heart diseases was the most common non-cancer cause of death in NPC patients.ConclusionsAlthough NPC remains the leading cause of death after NPC diagnosis, other non-NPC causes of death represent an increased number of death in NPC patients. These findings support the involvement of multidisciplinary care for follow-up strategy in NPC patients.

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Vertebral artery stenosis predicts cerebrovascular diseases following radiotherapy for nasopharyngeal carcinoma

Cited by 4 publications

References 27 publications

Vascular events in patients with head and neck cancer: A systematic review and meta‐analysis

Vascular events in patients with head and neck cancer: A systematic review and meta‐analysis

Vertebral and Carotid Artery Stenosis after Irradiation Both Raise Ischemic Stroke Risk in Head and Neck Cancer Patients

Cause of death during nasopharyngeal carcinoma survivorship: a population-based analysis

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