Intracranial aneurysms formation after radiotherapy for head and neck cancer: a 10-year nationwide follow-up study.

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.

• Authors: Wei-Hsun Yang, Yao-Hsu Yang, Pau-Chung Chen, Ting-Chung Wang, Ko-Jung Chen, Chun-Yu Cheng, Chia-Hsuan Lai
• Journal: BMC cancer (BMC Cancer) Vol. 19 Issue 1 Pg. 537 (Jun 04 2019) ISSN: 1471-2407 [Electronic] England
• PMID: 31164088 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Female
• Follow-Up Studies
• Humans
• Hypertension (complications)
• Incidence
• Intracranial Aneurysm (epidemiology, etiology)
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Nasopharyngeal Carcinoma (complications, radiotherapy)
• Proportional Hazards Models
• Radiation Dosage
• Radiotherapy (adverse effects)
• Risk Factors
• Sex Factors
• Taiwan (epidemiology)