BACKGROUND AND PURPOSE Several reports suggested that radiotherapy (RT) was related to an increased risk of cerebrovascular disease (CVD) in head and neck cancer (HNC) patients, but other risk factors of CVD were not properly considered in estimating the risk of RT. The purpose of this study is to analyze the effect of RT on the risk of CVD in HNC patients. MATERIALS AND METHODS The Korean Central Cancer Registry data and Korean National Health Insurance Service data were used. A total of 5570 patients with newly diagnosed HNC between the years 2003-2005 was included in our study cohort. We analyzed the effect of treatment modality and other socioeconomic variables on ischemic CVD incidence using the Cox proportional hazard regression model both in the entire cohort (n = 5570) and in the propensity score matching (PSM) cohort (n = 3310). RESULTS RT increased the CVD risk by 40.8% (aHR: 1.408, p = 0.006) in the entire cohort and by 44.3% (aHR: 1.443, p = 0.047) in the PSM cohort, respectively. CONCLUSION The risk of ischemic CVD increased by RT after adjusting for other socioeconomic and clinical risk factors. Regular follow up and appropriate screening for CVD are required for HNC patients who received RT, and focus should be on advanced-age patients with a low socioeconomic status and known clinical risk factors of CVD.

中文翻译：

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放疗可增加头颈癌患者发生缺血性脑血管疾病的风险：一项韩国人群队列研究

背景和目的 一些报告表明，放疗 (RT) 与头颈癌 (HNC) 患者的脑血管疾病 (CVD) 风险增加有关，但在估计放疗风险时并未适当考虑其他 CVD 风险因素。本研究的目的是分析放疗对 HNC 患者 CVD 风险的影响。材料和方法 使用韩国中央癌症登记数据和韩国国民健康保险服务数据。2003-2005 年间共有 5570 名新诊断的 HNC 患者被纳入我们的研究队列。我们在整个队列（n = 5570）和倾向评分匹配（PSM）队列（n = 3310）中使用 Cox 比例风险回归模型分析了治疗方式和其他社会经济变量对缺血性 CVD 发病率的影响。结果 RT 使整个队列的 CVD 风险增加了 40.8%（aHR：1.408，p = 0.006），PSM 队列中的 CVD 风险分别增加了 44.3%（aHR：1.443，p = 0.047）。结论 在调整其他社会经济和临床风险因素后，放疗会增加缺血性心血管疾病的风险。接受放疗的 HNC 患者需要定期随访和适当的 CVD 筛查，重点应关注社会经济地位低且已知 CVD 临床危险因素的高龄患者。