Intracranial aneurysms formation after radiotherapy for head and neck cancer: A 10-year nationwide follow-up study
Journal
BMC Cancer
Journal Volume
19
Journal Issue
1
Date Issued
2019
Author(s)
Abstract
Background: Intracranial aneurysms after radiotherapy (RT) have previously been reported. However, the majority of studies were case reports. Therefore, we performed a nationwide study to explore the risk of radiation-induced intracranial aneurysms. Methods: This study included patients diagnosed with head and neck cancer (ICD9: 140-149, 161). Intracranial aneurysms formation was identified using the following ICD9 codes: nonruptured cerebral aneurysm (ICD9:4373), aneurysm clipping (ICD9:3951). Patients who did not receive curative treatment and those with intracranial aneurysms before the diagnosis of head and neck cancer were excluded. Results: In total, 70,691 patients were included in the final analysis; they were categorized into the following three groups: nasopharyngeal carcinoma (NPC) with RT, non-NPC with RT, and non-NPC without RT. Patients in the NPC with RT group had the highest risk of developing intracranial aneurysms (hazard ratio (HR) 2.57; P < 0.001). In addition, hypertension was also a risk factor of developing intracranial aneurysms (HR 2.14; P < 0.01). The mean time interval from cancer diagnosis to intracranial aneurysm formation in the NPC with RT group was 4.3 ± 3.1 years. Conclusions: Compared with the non-NPC with RT and the non-NPC without RT groups, patients with NPC who received RT had a higher risk of developing intracranial aneurysms. ? 2019 The Author(s).
Subjects
Aneurysm; Head and neck cancer; Radiotherapy; Vasculopathy
SDGs
Other Subjects
adult; aged; aneurysm clipping; Article; cancer diagnosis; cancer radiotherapy; cancer risk; clinical evaluation; clinical feature; controlled study; disease course; female; follow up; head and neck cancer; high risk patient; human; hypertension; ICD-9; intracranial aneurysm; major clinical study; male; nasopharynx carcinoma; radiation hazard; risk assessment; risk factor; adverse event; complication; incidence; intracranial aneurysm; Kaplan Meier method; middle aged; proportional hazards model; radiation dose; sex factor; Taiwan; Adult; Aged; Female; Follow-Up Studies; Humans; Hypertension; Incidence; Intracranial Aneurysm; Kaplan-Meier Estimate; Male; Middle Aged; Nasopharyngeal Carcinoma; Proportional Hazards Models; Radiation Dosage; Radiotherapy; Risk Factors; Sex Factors; Taiwan
Publisher
BioMed Central Ltd.
Type
journal article