头颈部癌放疗患者的心血管风险与预防
Cardiovascular risk and prevention in patients with head and neck cancer treated with radiotherapy.
作者信息
Okoye Christian C, Bucher Jessica, Tatsuoka Curtis, Parikh Sahil A, Oliveira Guilherme H, Gibson Michael K, Machtay Mitchell, Yao Min, Zender Chad A, Dorth Jennifer A
机构信息
Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, Ohio.
Department of Neurology, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
出版信息
Head Neck. 2017 Mar;39(3):527-532. doi: 10.1002/hed.24646. Epub 2016 Dec 29.
BACKGROUND
The underlying contributors to cardiovascular disease (CVD) in patients with head and neck squamous cell carcinoma (HNSCC) are poorly characterized.
METHODS
Patients with HNSCC who underwent definitive or adjuvant (chemo)radiation between 2011 and 2013 were retrospectively reviewed. The 10-year risk estimates for a CVD event were calculated according to the Framingham Risk Score (FRS).
RESULTS
One hundred fifteen patients with predominantly stage III/IV HNSCC had a median follow-up of 2 years. At diagnosis, 23% of patients had CVD. The FRS was higher among patients with laryngeal cancer versus other sites (20.5% vs 14.4%). Twenty-four percent of all patients had uncontrolled blood pressure at diagnosis. Among the patients with CVD, 41% were not taking antiplatelet therapy and 30% were not taking statin therapy. Thirty-four percent of patients without CVD had indications for initiating statin therapy.
CONCLUSION
Patients with HNSCC have a high baseline CVD risk and many do not receive optimal preventive care. © 2016 Wiley Periodicals, Inc. Head Neck 39: 527-532, 2017.
背景
头颈部鳞状细胞癌（HNSCC）患者心血管疾病（CVD）的潜在促成因素尚不明确。
方法
对2011年至2013年间接受根治性或辅助性（化疗）放疗的HNSCC患者进行回顾性研究。根据弗雷明汉姆风险评分（FRS）计算CVD事件的10年风险估计值。
结果
115例主要为III/IV期HNSCC患者的中位随访时间为2年。诊断时，23%的患者患有CVD。喉癌患者的FRS高于其他部位患者（20.5%对14.4%）。所有患者中，24%在诊断时血压未得到控制。在患有CVD的患者中，41%未接受抗血小板治疗，30%未接受他汀类药物治疗。34%无CVD的患者有开始他汀类药物治疗的指征。
结论
HNSCC患者基线CVD风险较高，许多患者未接受最佳预防护理。©2016威利期刊公司。《头颈》39:527 - 532，2017。
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