Hypothyroidism and risks of cerebrovascular complications among patients with head and neck cancer after radiotherapy

Liu, Chi‐Hung; Chang, Joseph Tung-Chieh; Lee, Tsong‐Hai; Chang, Chien-Hung; Wu, Hsiu-Chuan; Chang, Ting‐Yu; Huang, Kuo‐Lun; Lin, Chien‐Yu; Fan, Kang‐Hsing; Chang, Yu‐Cheng

doi:10.1186/s12883-021-02047-5

Cited by 4 publications

(3 citation statements)

References 42 publications

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“…A total of 146 studies were ultimately included in our meta‐analysis 9,24–167 . A PRISMA diagram outlining our search is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Vascular events in patients with head and neck cancer: A systematic review and meta‐analysis

Monaghan,

Duckett,

Nguyen

et al. 2024

Head & Neck

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ObjectiveTo assess the incidence of vascular events in patients with head and neck cancer.Review MethodsPrimary studies identified through April 2023. Meta‐analysis was performed.ResultsThere were 146 studies included in the systematic review. Rates of events were collected in the overall group, those with chemoprophylaxis, and those that underwent surgery, radiation, or chemotherapy. Of 1 184 160 patients, 4.3% had a vascular event. Radiation therapy had highest risk of overall events and stroke when compared to surgery and chemotherapy. Chemotherapy had a higher risk of stroke and overall events when compared to surgery.ConclusionsVascular events occur in 4%–5% of patients with head and neck cancer. Our data does not support the use of routine anticoagulation. Patients undergoing radiation therapy had the highest frequency of events.

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“…A total of 146 studies were ultimately included in our meta‐analysis 9,24–167 . A PRISMA diagram outlining our search is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Vascular events in patients with head and neck cancer: A systematic review and meta‐analysis

Monaghan,

Duckett,

Nguyen

et al. 2024

Head & Neck

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“…Liu et al . [ 79 ] also found the prevalence of post-RT hypothyroidism might increase to 50% with time. They hypothesized that hypothyroidism may raise atherogenic risks and assessed the association between post-RT hypothyroidism and carotid artery stenosis.…”

Section: Taiwanese Datamentioning

confidence: 99%

Application of Carotid Duplex Ultrasonography in the Surveillance of Carotid Artery Stenosis after Neck Irradiation

Kuo¹,

Wu²,

Hsieh³

et al. 2022

Rev. Cardiovasc. Med.

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Head and neck cancer (HNC) shares some risk factors with cardiovascular disease. Neck radiotherapy (RT) causes carotid artery injury and stenosis. In HNC patients treated with RT, the prevalence rate of severe (>70%) carotid artery stenosis is >10%, and the cumulative incidence continuously increases over time. There is at least a two-fold risk of cerebrovascular events in these patients compared with the normal population. Carotid artery stenosis is mainly assessed and diagnosed via duplex ultrasonography. Angioplasty and stenting may be recommended to patients who developed severe post-irradiation carotid artery stenosis. This review assessed Taiwanese data that provided some recommendations for HNC patients treated with RT. With consideration of the high prevalence rate of carotid artery stenosis after neck irradiation, duplex ultrasonography should be included in the follow-up workup.

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“…Among them, RIHT is the most common [ 3 ]. Hypothyroidism increases the risk of atherosclerosis [ 4 ], thereby increasing the incidence and mortality of cardiovascular and cerebrovascular diseases and ultimately greatly reducing the quality of life of patients [ 5 – 7 ]. According to relevant literature reports, the incidence of hypothyroidism 2 years after radiotherapy is 40% to 50%, of which subclinical hypothyroidism accounts for 70% and clinical hypothyroidism accounts for 30% [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of correlative risk factors for radiation-induced hypothyroidism in head and neck tumors

Wang,

Hou,

Wang

et al. 2024

BMC Cancer

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Objective The aim of the study is to identify clinical and dosimetric factors that could predict the risk of radiation-induced hypothyroidism(RIHT) in head and neck cancer(HNC) patients following intensity-modulated radiotherapy(IMRT). Methods A total of 103 HNC patients were included in our study. General clinical characteristic and dosimetric data of all recruited patients were analyzed, respectively. The univariate and multivariate logistic regression anlalysis were successively conducted to identify optimal predictors, which aim to construct the nomogram. And the joint prediction was performed. Results The incidence of patients with HNC was 36.9% (38/103). Among the clinical factors, gender, N stage, chemotherapy, frequency of chemotherapy and surgery involving the thyroid were related to RIHT. Logistic regression analysis showed that thyroid volume, Dmean, VS45, VS50, VS60 and V30,60 were independent predictors of RIHT, which were also incorporated in the nomogram. An AUC of 0.937 (95%CI, 0.888–0.958) also was showed outstanding resolving ability of the nomogram. When the volume of the thyroid was greater than 10.6 cm3, the incidence of RIHT was 14.8%, and when the volume of the thyroid was equal to or smaller than 10.6 cm3, the incidence was 72.5%. The incidence rates of RIHT in the group with VS60≦8.4cm3 and VS60 > 8.4cm3 were 61.4% and 19.3%, respectively. Conclusions Thyroid volume and thyroid VS60 are independent predictors of RIHT in patients with HNC. Moreover, more attention should be paid to patients with thyroid volume ≤ 10.6cm3. Thyroid VS60 > 8.4cm3 may be a useful threshold for predicting the development of RIHT. The nomogram conducted by the research may become a potential and valuable tool that could individually predict the risk of RIHT for HNC patients.

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Hypothyroidism and risks of cerebrovascular complications among patients with head and neck cancer after radiotherapy

Cited by 4 publications

References 42 publications

Vascular events in patients with head and neck cancer: A systematic review and meta‐analysis

Vascular events in patients with head and neck cancer: A systematic review and meta‐analysis

Application of Carotid Duplex Ultrasonography in the Surveillance of Carotid Artery Stenosis after Neck Irradiation

Analysis of correlative risk factors for radiation-induced hypothyroidism in head and neck tumors

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