Lin Ping-Yi, Cheng Ping-Chia, Hsu Wan-Lun, Lo Wu-Chia, Hsieh Chen-Hsi, Shueng Pei-Wei, Liao Li-Jen
Oral Maxillofacial Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.
Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan.
Front Oncol. 2022 Jun 1;12:820808. doi: 10.3389/fonc.2022.820808. eCollection 2022.
The relative risk for cerebrovascular disease (CVD) is increased in patients with head and neck cancer (HNC) treated with radiotherapy (RT). However, the current relative risk for CVD following RT has not been well clarified. The purpose of this study was to analyze the effect of RT and update the risk of CVD following RT in HNC patients through a systematic review and meta-analysis.
We conducted an online database search and systematic review of observational studies that reported on CVD and extracranial carotid stenosis in patients with HNC who had undergone RT. Articles published in Medline and PubMed from 1980 to 2021 were identified and collected.
Of the forty-seven articles identified from PubMed and forty-four articles identified from 3 systematic reviews, twenty-two studies were included. We found that neck RT was a significant risk factor for CVD (HR 3.97, 95% CI: 2.89-5.45). Patients with HNC treated by RT had an increased OR (7.36, 95% CI: 4.13-13.11) for CVD, and approximately 26% (95% CI: 22%-31%) of HNC patients treated with RT were at risk for CVD with more than 50% reduction in carotid diameter.
The risk of CVD is increased in patients with HNC treated by RT, and recent improvements in RT techniques may have contributed to the decreased risk of CVD. These results suggest that regular follow-up and appropriate screening for CVD should be required for patients with HNC.
接受放射治疗（RT）的头颈癌（HNC）患者发生脑血管疾病（CVD）的相对风险增加。然而，目前RT后CVD的相对风险尚未得到很好的阐明。本研究的目的是通过系统评价和荟萃分析，分析RT的效果并更新HNC患者RT后CVD的风险。
我们对报道接受RT的HNC患者CVD和颅外颈动脉狭窄的观察性研究进行了在线数据库搜索和系统评价。检索并收集了1980年至2021年发表在Medline和PubMed上的文章。
从PubMed中识别出47篇文章，从3篇系统评价中识别出44篇文章，纳入了22项研究。我们发现颈部RT是CVD的一个重要危险因素（HR 3.97，95%CI：2.89 - 5.45）。接受RT治疗的HNC患者发生CVD的OR值增加（7.36，95%CI：4.13 - 13.11），接受RT治疗的HNC患者中约26%（95%CI：22% - 31%）有发生CVD的风险，颈动脉直径减少超过50%。
接受RT治疗的HNC患者发生CVD的风险增加，RT技术的近期改进可能有助于降低CVD风险。这些结果表明，HNC患者应进行定期随访和适当的CVD筛查。
