TY - JOUR
T1 - Risk of fatal cerebrovascular accidents after external beam radiation therapy for early-stage glottic laryngeal cancer
AU - Swisher-Mcclure, Samuel
AU - Mitra, Nandita
AU - Lin, Alexander
AU - Ahn, Peter
AU - Wan, Fei
AU - O'Malley, Bert
AU - Weinstein, Gregory S.
AU - Bekelman, Justin E.
PY - 2014/5
Y1 - 2014/5
N2 - Background This study compared the risk of fatal cerebrovascular accidents (CVAs) in patients with early-stage glottic laryngeal cancer receiving surgery or external beam radiation therapy (EBRT). Methods Using a competing risks survival analysis, we compared the risk of death because of CVA among patients with early-stage glottic laryngeal cancer receiving surgery or EBRT in the Surveillance, Epidemiology, and End Results (SEER) database. Results The cumulative incidence of fatal CVA at 15 years was higher in patients receiving EBRT (2.8%; 95% confidence interval [CI], 2.3% to 3.4%) compared to surgery (1.5%; 95% CI, 0.8% to 2.3%; p = .024). In multivariable competing risks regression models, EBRT remained associated with an increased risk of fatal CVA compared to surgery (adjusted hazard ratio [HR], 1.75; 95% CI, 1.04-2.96; p = .037). Conclusion Treatment for early-stage glottic laryngeal cancer with EBRT was associated with a small increase in the risk of late fatal CVA events relative to surgery.
AB - Background This study compared the risk of fatal cerebrovascular accidents (CVAs) in patients with early-stage glottic laryngeal cancer receiving surgery or external beam radiation therapy (EBRT). Methods Using a competing risks survival analysis, we compared the risk of death because of CVA among patients with early-stage glottic laryngeal cancer receiving surgery or EBRT in the Surveillance, Epidemiology, and End Results (SEER) database. Results The cumulative incidence of fatal CVA at 15 years was higher in patients receiving EBRT (2.8%; 95% confidence interval [CI], 2.3% to 3.4%) compared to surgery (1.5%; 95% CI, 0.8% to 2.3%; p = .024). In multivariable competing risks regression models, EBRT remained associated with an increased risk of fatal CVA compared to surgery (adjusted hazard ratio [HR], 1.75; 95% CI, 1.04-2.96; p = .037). Conclusion Treatment for early-stage glottic laryngeal cancer with EBRT was associated with a small increase in the risk of late fatal CVA events relative to surgery.
KW - cerebrovascular accidents
KW - laryngeal cancer
KW - radiation therapy
UR - http://www.scopus.com/inward/record.url?scp=84899074023&partnerID=8YFLogxK
U2 - 10.1002/hed.23342
DO - 10.1002/hed.23342
M3 - Article
C2 - 23595858
AN - SCOPUS:84899074023
SN - 1043-3074
VL - 36
SP - 611
EP - 616
JO - Head & Neck
JF - Head & Neck
IS - 5
ER -