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Radiotherapy Is Associated with an Accelerated Risk of Ischemic Stroke in Oral Cavity Cancer Survivors after Primary Surgery

The number of oral cavity carcinoma (OCC) survivors continues to increase due to advances in definitive surgery and radiation therapy (RT), however the risk of ischemic stroke is unclear in long-term survivors. In this study, survivors are defined as those who survived for >5 years after a diagno...

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Autores principales: Kuan, Feng-Che, Lee, Kuan-Der, Huang, Shiang-Fu, Chen, Ping-Tsung, Huang, Cih-En, Wang, Ting-Yao, Chen, Min-Chi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139411/
https://www.ncbi.nlm.nih.gov/pubmed/32155918
http://dx.doi.org/10.3390/cancers12030616
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author Kuan, Feng-Che
Lee, Kuan-Der
Huang, Shiang-Fu
Chen, Ping-Tsung
Huang, Cih-En
Wang, Ting-Yao
Chen, Min-Chi
author_facet Kuan, Feng-Che
Lee, Kuan-Der
Huang, Shiang-Fu
Chen, Ping-Tsung
Huang, Cih-En
Wang, Ting-Yao
Chen, Min-Chi
author_sort Kuan, Feng-Che
collection PubMed
description The number of oral cavity carcinoma (OCC) survivors continues to increase due to advances in definitive surgery and radiation therapy (RT), however the risk of ischemic stroke is unclear in long-term survivors. In this study, survivors are defined as those who survived for >5 years after a diagnosis of OCC. They were matched at a 1:5 ratio with normal controls. Those who received surgery alone versus surgery+RT were also matched at a 1:1 ratio. From 2000 to 2005, 5172 OCC survivors who received surgery alone (n = 3205) or surgery+RT (n = 1967), and 25,860 matched normal controls were analyzed using stratified Cox regression models. Adjusted HRs (aHR) revealed that the surgery+RT group (aHR = 1.68, p < 0.001) had an elevated risk of stroke, but this was not seen in the surgery alone group (aHR = 0.99, p = 0.953). Furthermore, the age at stroke onset was at least 10 years earlier in the surgery+RT group than in the controls. In conclusion, radiotherapy increased the risk of ischemic stroke by 68% and also accelerated the onset of stroke in long-term OCC survivors after primary surgery compared with matched normal controls. Secondary prevention should include stroke as a late complication in OCC survivorship programs.
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spelling pubmed-71394112020-04-10 Radiotherapy Is Associated with an Accelerated Risk of Ischemic Stroke in Oral Cavity Cancer Survivors after Primary Surgery Kuan, Feng-Che Lee, Kuan-Der Huang, Shiang-Fu Chen, Ping-Tsung Huang, Cih-En Wang, Ting-Yao Chen, Min-Chi Cancers (Basel) Article The number of oral cavity carcinoma (OCC) survivors continues to increase due to advances in definitive surgery and radiation therapy (RT), however the risk of ischemic stroke is unclear in long-term survivors. In this study, survivors are defined as those who survived for >5 years after a diagnosis of OCC. They were matched at a 1:5 ratio with normal controls. Those who received surgery alone versus surgery+RT were also matched at a 1:1 ratio. From 2000 to 2005, 5172 OCC survivors who received surgery alone (n = 3205) or surgery+RT (n = 1967), and 25,860 matched normal controls were analyzed using stratified Cox regression models. Adjusted HRs (aHR) revealed that the surgery+RT group (aHR = 1.68, p < 0.001) had an elevated risk of stroke, but this was not seen in the surgery alone group (aHR = 0.99, p = 0.953). Furthermore, the age at stroke onset was at least 10 years earlier in the surgery+RT group than in the controls. In conclusion, radiotherapy increased the risk of ischemic stroke by 68% and also accelerated the onset of stroke in long-term OCC survivors after primary surgery compared with matched normal controls. Secondary prevention should include stroke as a late complication in OCC survivorship programs. MDPI 2020-03-06 /pmc/articles/PMC7139411/ /pubmed/32155918 http://dx.doi.org/10.3390/cancers12030616 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kuan, Feng-Che
Lee, Kuan-Der
Huang, Shiang-Fu
Chen, Ping-Tsung
Huang, Cih-En
Wang, Ting-Yao
Chen, Min-Chi
Radiotherapy Is Associated with an Accelerated Risk of Ischemic Stroke in Oral Cavity Cancer Survivors after Primary Surgery
title Radiotherapy Is Associated with an Accelerated Risk of Ischemic Stroke in Oral Cavity Cancer Survivors after Primary Surgery
title_full Radiotherapy Is Associated with an Accelerated Risk of Ischemic Stroke in Oral Cavity Cancer Survivors after Primary Surgery
title_fullStr Radiotherapy Is Associated with an Accelerated Risk of Ischemic Stroke in Oral Cavity Cancer Survivors after Primary Surgery
title_full_unstemmed Radiotherapy Is Associated with an Accelerated Risk of Ischemic Stroke in Oral Cavity Cancer Survivors after Primary Surgery
title_short Radiotherapy Is Associated with an Accelerated Risk of Ischemic Stroke in Oral Cavity Cancer Survivors after Primary Surgery
title_sort radiotherapy is associated with an accelerated risk of ischemic stroke in oral cavity cancer survivors after primary surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139411/
https://www.ncbi.nlm.nih.gov/pubmed/32155918
http://dx.doi.org/10.3390/cancers12030616
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