在头部和部癌症的幸存者中发生中风的风险
Pui Lam Yip1, Huili Zheng2, Timothy Cheo1
1Department of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore, Singapore.
JAMA network open
|February 13, 2024
概括
头癌 (HNC) 的幸存者面临着明显更高的中风风险,特别是那些接受放射治疗的人. 早期查和干预对于这种高风险人群至关重要.
科学领域:
- 在瘤学瘤学.
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 头癌 (HNC) 幸存者患中风的风险较高.
- 为了制定有效的生存策略,需要对HNC幸存者亚群中中风风险的全面数据.
研究的目的:
- 为了确定新加坡头癌幸存者的各种亚群中风风险.
- 确定与中风风险增加相关的特定的人口,疾病和治疗因素.
主要方法:
- 一项全国性的,基于注册的,横截面研究利用了来自新加坡癌症注册和新加坡中风注册 (2005-2020) 的数据.
- 国际疾病分类代码 (ICD-9-CM,ICD-10-AM) 用于识别HNC幸存者和中风诊断.
- 根据年龄标准化的发病率比率 (SIRR) 和差异 (SIRD) 计算,将HNC幸存者与新加坡普通人口进行比较.
主要成果:
- 分析了9803名HNC幸存者;在随访期间,3.4%的人患上中风.
- 整体中风风险显著增加 (SIRR=2.46,SIRD=4.11每1000人年).
- 年轻的幸存者 (<40岁) 的风险明显更高 (SIRR=30.55).
- 在大多数HNC子站点,阶段和治疗方式中观察到中风风险增加.
- 与手术 (SIRR=1.64) 相比,放射治疗与较高的中风风险 (SIRR=3.01) 有关.
结论:
- 头癌幸存者表现出大量增加的缺血性和出血性中风的风险.
- 这种高风险覆盖了各种人口和临床子组,强调了需要量身定制的监测.
- 这些发现强调了早期中风查和主动干预策略对HNC幸存者的关键重要性,特别是那些接受放射治疗的人.
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